ORCID Profile
0000-0003-0832-0861
Current Organisations
Aarhus University
,
Syddansk Universitet Det Naturvidenskabelige Fakultet
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Publisher: MDPI AG
Date: 09-11-2018
DOI: 10.3390/INFORMATICS5040041
Abstract: Background: The WHO framework on integrated people-centred health services promotes a focus on the needs of people and their communities to empower them to have a more active role in their own health. It has advocated five strategies including: Engaging and empowering people and communities co-ordinating services within and across sectors and, creating an enabling environment. Any implementation of these strategies needs to occur at in idual, community, and health service levels. Useful steps to reorganising health service provision are already being guided by existing models of care linked to increased adoption and use of digital technologies with ex les including: Wagner’s Chronic Care Model (CCM) Valentijn’s Rainbow Model of Integrated Care (RMIC) and Phanareth’s et al.’s Epital Care Model (ECM). However, what about in iduals and the communities they live in? How will strategies be implemented to address known inequities in: the social determinants of health access to, and use of digital technologies, and in idual textual, technical, and health literacies? Proposal of a matrix framework: This paper argues that people with complex and chronic conditions (PwCCC) living in communities that are at risk of being under-served or marginalised in health service provision require particular attention. It articulates a step-by-step process to identify these in iduals and co-produce mechanisms to engage, empower and ultimately emancipate these in iduals to become activated in living with their conditions and in their interactions with the health system and community. This step-by-step process focuses on key issues related to the design and role of digital services in mitigating the effects of the health service inequity and avoiding the creation of an e-health ide amongst users when advocating digital behaviour change initiatives. This paper presents a matrix framework providing a scaffold across three inter-related levels of the in idual the provider, and the health and care system. The matrix framework supports examination of and reflection on the design and role of digital technologies in conjunction with pre-existing motivational instruments. This matrix framework is illustrated with ex les from practice. Conclusion: It is anticipated that the matrix framework will evolve and can be used to map and reflect on approaches and practices aiming to enrich and stimulate co-production activities supported by digital technology focused on enhancing people-centred health services for the marginalised.
Publisher: MDPI AG
Date: 07-12-2020
DOI: 10.3390/LIFE10120329
Abstract: Health care systems struggle to consistently deliver integrated high-quality, safe, and patient-centered care to all in an economically sustainable manner. Inequity of access to health care services and variation in diagnostic and treatment outcomes are common. Further, as health care systems become ever more complex, iatrogenesis and counter productivity have emerged as real dangers. In exploring this paradox, this paper considers a subset of those in society living with chronic conditions. Their attributes and circumstances have led to them being marginalized or excluded from ‘end-user’ engagement and/or from their requirements being incorporated into technology supported chronic disease management initiatives. Significantly, these citizens are often the most vulnerable and socially disadvantaged and tend to achieve poorer results and cost more per capita than the ‘average patient’ in their interactions with the health care system. Critically, this paper argues that a truly people-centered technology supported chronic care system can only be designed by understanding and responding to the needs, attributes and capabilities of the most vulnerable in society. This paper suggests innovative ways of supporting interactions with these ‘end-users’ and highlights how reflection on these approaches can contribute to emancipating the health system to move towards more socially inclusive eHealth solutions.
Location: Denmark
Location: Denmark
No related grants have been discovered for Sidsel Maria Monrad Villumsen.