Personal digital health hubs for multiple conditions

Abstract

Multimorbidity is the presence of more than one chronic disease condition in an individual. Health-related, socioeconomic, cultural and environmental factors, as well as patient behaviour, all influence the outcomes of multimorbidity. Addressing these complex and often interacting biopsychosocial factors therefore requires a shift in treatment from a physical damage model towards person-centred integrated care with increased patient agency. Education influences behaviour and can be used to empower patients and their carers with greater agency, thus allowing greater responsibility for and control over the management of patient care. In this paper we reflect on our own learning as a community of health practitioners from different disciplines. Recognizing the increasing importance of patient agency in driving the evolution of health care, we describe the concept of a web-based personal digital health hub for integrated patient care. Informed by collaboration between patient, health and education communities, we share our early experience in the implementation of a health hub around a cohort of patients with hip fractures. We also describe a vision for future health care based on the co-creation of digital health hubs centred on patients’ and carers’ needs. The health hub could allow important advances and efficiencies to be achieved in workforce practice and education; patient and carer engagement in self-care; and the collection of patient-reported health data required for ongoing research and improvements in health care.

“Context, content, and system” supporting digital health hub (DHH)–enabled models of care (MoCs) for fragility hip fractures: perspectives of diverse multidisciplinary stakeholders in South Australia from qualitative in-depth interviews

“…Compared to the last decade, there has been a rapid increase in the availability of digital health solutions by a variety of vendors, including health agencies, fitness advocates, and software companies. These applications are primarily designed to support consumers in the domain of general lifestyle and wellness, while some have been developed to support self-management of chronic disease conditions such as diabetes [ 5 , 18 , 45 ]. At the time when this study was conducted, we only had a theoretical concept of a digital health solution to be co-designed with relevant stakeholders.…”

“…At the time when this study was conducted, we only had a theoretical concept of a digital health solution to be co-designed with relevant stakeholders. However, with critical insights from this study, including the characterization of DHH and findings from other research components [ 1 , 4 , 5 , 7 , 9 ], we have been able to advance our concept to the stage of a prototype to be tested in a real-world practice setting in the next stage of our research program. The DHH-enabled MoC will be structured to provide information related to not only hip fractures but also general health and wellbeing, including nutrition, exercise, sleep, and mental health, combined with past medical history [ 5 ].…”

“…However, with critical insights from this study, including the characterization of DHH and findings from other research components [ 1 , 4 , 5 , 7 , 9 ], we have been able to advance our concept to the stage of a prototype to be tested in a real-world practice setting in the next stage of our research program. The DHH-enabled MoC will be structured to provide information related to not only hip fractures but also general health and wellbeing, including nutrition, exercise, sleep, and mental health, combined with past medical history [ 5 ]. We recommend wider consultations across a range of practice environments or specialty groups so that tailored innovative services can be negotiated, developed, and tested for implementation.…”

“…Multimorbidity is the presence of more than one chronic condition in an individual. It is influenced not only by health-related characteristics but also by socioeconomic, cultural, and environmental factors, as well as patient behavior [ 5 ]. It is argued that the current health system is predominantly geared toward labeling and addressing chronic disease through siloed care pathways rather than having a wider view of disease etiology and interacting factors [ 6 ].…”

Towards AI-Enabled Multimodal Diagnostics and Management of COVID-19 and Comorbidities in Resource-Limited Settings

“…Thus, the existence of a large population of people with comorbidities in SSA countries makes it more difficult to manage cases of COVID-19 worsened by co-infection. For these types of patients, it is more difficult to determine the pattern of progression of their preexisting conditions in the presence of COVID-19 and the impact these comorbidities have on the best form of personalized care that is required to treat them for their COVID-19 infection [5,6]. Currently, difficulties exist in the area of active case finding due to weak disease surveillance infrastructures, low testing capacity particularly in rural areas, and many RLS in these countries.…”