What is person-centred eHealth?

What is person-centred eHealth? Does the wording imply that ehealth in general is not person-centred. Well. To elaborate these questions further, I need to make some assumption and define what I mean by person-centred care and eHealth.  Ehealth is according to  Eysenbach et al (2001) ” an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology”.

EHealth is not a technical solutions per se, it is also a state of mind and attitude about how we want to communicate and in that sense it could be a good tool in providing support for PCC. The core in my exposition is grounded on the definition of PCC found within GPCC. I have already discussed this in my previous blogs, and will for the matter of simplicity call it gPCC (Gothenburg person-centred care approach). The most central aspect in gPCC is the mutual acceptance that a person always is intradependent of the other person. At the core of the definition is the concept of partnership. The juridical meaning of the word is that two persons reach an written or verbal agreement (contract) to perform certain commitments. Within the gPCC approach, this agreement would be manifested by a health and care plan that is agreed upon by all involved stakeholders.  So partnership needs at least two people that agree upon a certain approach in order to reach a certain outcomes.

This puts the work done by each of the stakeholders prior to the agreement  in a central position. Modern technology  and eHealth has allowed us to monitor our personal life and the disease progress both on a subjective as well as objective basis. Let me take an example:  One of the more trendy words right now is “quantified-self”, a phenomena that Gary Wolf from Wyred magazine talks about in a Ted Talk episode. Other innovations like the Swedish kick-starter project Memoto or Google’s Glass project are other examples of how we as individuals may collect data to quantify our selfes and in the future maybe our symptoms. Symptoms are a persons subjective perception of illness, perceptible and communicated only by the  personal narrative. On the other side of the coin we have signs that are more and more used for “big data “ i.e. objective signs that can be measured, quantified and analysed for statistical purpose. One of the most advanced clinical tools for this is the IBM Watson. In medicine, signs  are the objective evidence or indication of disease, hence are important tools when diagnosing and as well as when treating medical condition of the patient. However, and this is my take home message, while both sides of the coin (symptom perception and measurement of objective signs) are equal important, it is first when the development of a mutual agreement is put the centre of the care in a notion of equality and intradependency that gPCC occurs. And in that sense, there are still very few if any person-centred eHealth solutions in research as well as the clinical practice (Swedberg, K., Wolf, A., Ekman, I., 2011. Telemonitoring in patients with heart failure. New England Journal of Medicine 364 (11), 1078; author reply 1079-1080.)

PDF presentation about eHealth and PCC

Person-centred ehealth is about_

 

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