Research

Concept and methodology

Shared care in forms of communication, collaboration and coordination among healthcare professionals and between these professionals and their patients has a high priority in European countries.

Problem statement

The problem statement of the project is:

How to adequately model and build socio-technical solutions that explicitly support the interdependent roles of patients and healthcare professionals.

An idea of the project is that healthcare work is highly interactive and communicative in nature, and that optimal outcomes are achieved when patients become active participants in the healthcare process.

Thus the project will contribute new knowledge in the form of models, conceptual frameworks, and prototypes of it-support for communication across institutional and professional boundaries in highly heterogeneous groups of people.

Addressing Shared Care

Establishing good communication across organizational and professional boundaries is the most crucial aspect to successful shared care programs. Shared care applies when the responsibility for the healthcare of the patient is shared between individuals or teams who are parts of separate organizations, or where substantial organizational boundaries exist.

Shared care programs focus on improving coordination, collaboration and knowledge sharing among healthcare professionals as well as involving patients as active participants in these processes.

Research has shown that shared care programs can improve quality and efficiency of care significantly, but also that the implementation of such programs is a long term and difficult process. Effective shared care requires that healthcare professionals share information about (and with) patients at appropriate points in the care and/or treatment process.

Telemedicine and Shared Care

The combination of telemedicine and shared care programs addresses the problem of supporting communication across institutional and professional boundaries, in highly heterogeneous networks of healthcare professionals and patients. This is not a simple or straightforward task. Research on organizational communication has consistently shown that working across functional boundaries and sharing knowledge is difficult, because knowledge is localized, embedded and invested in practice. Thus, the development of successful IT solutions for shared care requires overcoming the “knowledge boundaries” that exist between different professions and groups in the healthcare system.

The hypotheses

The overall hypothesis of this project is that it is possible to develop the conceptual basis for such IT-solutions. We further hypothesize that for the solutions to be successful a socio-technical perspective needs to be applied.

In this context it means that telemonitoring and new it-applications and -services supporting a shared care paradigm need to be co-constructed together with new treatment plans, clinical practices and more active roles for patients. We will challenge these hypotheses by following a proof-of-concept approach.

We hypothesize that IT applications building on the ideas of shared care may be designed to improve enablers and reduce barriers for supplementing/substituting some of the patients’ visits to The Heart Centre with self care, visits to GPs or local hospitals. Many patients with chronic diseases have a high morbidity, mortality and need for frequent ambulatory visits. Furthermore, some of these patients (e.g. patients with heart failure or diabetes) have more and more technologically advanced medical devices implanted in their body or at their disposal when they are discharged from the clinic.