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Graffigna G, Barello S. How does patient engagement work in a real-world setting? Recommendations, caveats, and challenges from a psychosocial perspective. PATIENT EDUCATION AND COUNSELING 2022; 105:3567-3573. [PMID: 36008187 DOI: 10.1016/j.pec.2022.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To propose a possible taxonomy for diverse stakeholders outside the healthcare communication field and to promote meaningful patient engagement in healthcare settings. Moreover, to support them in making more coherent policy, strategy, and practice decisions to enhance patient participation in their healthcare systems. DISCUSSION This paper is part of the pEACH Position Papers Series and provides a critical and experience-based reflection on patient engagement in different healthcare-related settings. We propose a framework that operationalises actionable patient engagement at the micro-meso-macro levels. Finally, the authors will highlight some "points of attention" that need to be addressed to support patient engagement implementation in healthcare organisations. CONCLUSION AND PRACTICE IMPLICATIONS Understanding and systematising the established meanings of patient engagement through a psychosocial lens is critical to addressing the following questions: "how can various health care organisations ensure that authentic patient engagement informs decision-making and strategies", "how can these organisations build authentic connections with their patients", and importantly, "how can patients gain valuable and reliable insights through patient engagement"? Answering these questions can enable key stakeholders to make informed decisions that ensure the quality and effectiveness of patient engagement initiatives in different healthcare settings.
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Affiliation(s)
- Guendalina Graffigna
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan and Cremona, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123 Milan, Italy; Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Via Bissolati 74, 26100 Cremona, Italy
| | - Serena Barello
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan and Cremona, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123 Milan, Italy; Faculty of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123 Milan, Italy.
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Partogi M, Gaviria-Valencia S, Alzate Aguirre M, Pick NJ, Bhopalwala HM, Barry BA, Kaggal VC, Scott CG, Kessler ME, Moore MM, Mitchell JD, Chaudhry R, Bonacci RP, Arruda-Olson AM. Sociotechnical Intervention for Improved Delivery of Preventive Cardiovascular Care to Rural Communities: Participatory Design Approach. J Med Internet Res 2022; 24:e27333. [PMID: 35994324 PMCID: PMC9446142 DOI: 10.2196/27333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 12/30/2021] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
Abstract
Background Clinical practice guidelines recommend antiplatelet and statin therapies as well as blood pressure control and tobacco cessation for secondary prevention in patients with established atherosclerotic cardiovascular diseases (ASCVDs). However, these strategies for risk modification are underused, especially in rural communities. Moreover, resources to support the delivery of preventive care to rural patients are fewer than those for their urban counterparts. Transformative interventions for the delivery of tailored preventive cardiovascular care to rural patients are needed. Objective A multidisciplinary team developed a rural-specific, team-based model of care intervention assisted by clinical decision support (CDS) technology using participatory design in a sociotechnical conceptual framework. The model of care intervention included redesigned workflows and a novel CDS technology for the coordination and delivery of guideline recommendations by primary care teams in a rural clinic. Methods The design of the model of care intervention comprised 3 phases: problem identification, experimentation, and testing. Input from team members (n=35) required 150 hours, including observations of clinical encounters, provider workshops, and interviews with patients and health care professionals. The intervention was prototyped, iteratively refined, and tested with user feedback. In a 3-month pilot trial, 369 patients with ASCVDs were randomized into the control or intervention arm. Results New workflows and a novel CDS tool were created to identify patients with ASCVDs who had gaps in preventive care and assign the right care team member for delivery of tailored recommendations. During the pilot, the intervention prototype was iteratively refined and tested. The pilot demonstrated feasibility for successful implementation of the sociotechnical intervention as the proportion of patients who had encounters with advanced practice providers (nurse practitioners and physician assistants), pharmacists, or tobacco cessation coaches for the delivery of guideline recommendations in the intervention arm was greater than that in the control arm. Conclusions Participatory design and a sociotechnical conceptual framework enabled the development of a rural-specific, team-based model of care intervention assisted by CDS technology for the transformation of preventive health care delivery for ASCVDs.
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Does Day of Surgery Affect Hospital Length of Stay and Charges Following Minimally Invasive Transforaminal Lumbar Interbody Fusion? Clin Spine Surg 2018; 31:E291-E295. [PMID: 29608450 DOI: 10.1097/bsd.0000000000000640] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
STUDY DESIGN Retrospective Cohort. OBJECTIVE To determine if an association exists between surgery day and length of stay or hospital costs after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARYOF BACKGROUND DATA Length of inpatient stay after orthopedic procedures has been identified as a primary cost driver, and previous research has focused on determining risk factors for prolonged length of stay. In the arthroplasty literature, surgery performed later in the week has been identified as a predictor of increased length of stay. However, no such investigation has been performed for MIS TLIF. MATERIALS AND METHODS A surgical registry of patients undergoing MIS TLIF between 2008 and 2016 was retrospectively reviewed. Patients were grouped based on day of surgery, with groups including early surgery and late surgery. Day of surgery group was tested for an association with demographics and perioperative variables using the student t test or χ analysis. Day of surgery group was then tested for an association with direct hospital costs using multivariate linear regression. RESULTS In total, 438 patients were analyzed. In total, 51.8% were in the early surgery group, and 48.2% were in the late surgery group. There were no differences in demographics between groups. There were no differences between groups with regard to operative time, intraoperative blood loss, length of stay, or discharge day. Finally, there were no differences in total hospital charges between early and late surgery groups (P=0.247). CONCLUSIONS The specific day on which a MIS TLIF procedure occurs is not associated with differences in length of inpatient stay or total hospital costs. This suggests that the postoperative course after MIS TLIF procedures is not affected by the differences in hospital staffing that occurs on the weekend compared with weekdays.
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Edelman A, Taylor J, Ovseiko PV, Topp SM. The role of academic health centres in improving health equity: a systematic review. J Health Organ Manag 2018; 32:279-297. [PMID: 29624138 DOI: 10.1108/jhom-09-2017-0255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose Academic health centres (AHCs) are organisations that pursue a "tripartite" mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity. Design/methodology/approach Peer-reviewed and grey literature published in English between 2000 and 2016 were searched. Articles that identified AHCs as the primary unit of analysis and that also addressed health equity concepts in relation to the AHC's activity or role were included. Findings In total, 103 publications met the inclusion criteria of which 80 per cent were expert opinion. Eight descriptive themes were identified through which health equity concepts in relation to AHCs were characterised, described and operationalised: population health, addressing health disparities, social determinants of health, community engagement, global health, health system reform, value-based and accountable financing models, and role clarification/recalibration. There was consensus that AHCs can and should address health disparities, but there is a lack of empirical evidence to show that AHCs have a capacity to contribute to health equity goals or are demonstrating this contribution. Originality/value This review highlights the relevance of health equity concepts in discussions about the role and missions of AHCs. Future research should improve the quality of the evidence base by empirically examining health equity strategies and interventions of AHCs in multiple countries and contexts.
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Affiliation(s)
- Alexandra Edelman
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University , Townsville, Australia
| | - Judy Taylor
- College of Medicine and Dentistry, Division of Tropical Health and Medicine, James Cook University , Townsville, Australia
| | - Pavel V Ovseiko
- Radcliffe Department of Medicine, Medical Sciences Division, John Radcliffe Hospital, University of Oxford , Oxford, UK
| | - Stephanie M Topp
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University , Townsville, Australia
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Polverini PJ, Krebsbach PH. Research and Discovery Science and the Future of Dental Education and Practice. J Dent Educ 2017; 81:eS97-eS107. [PMID: 28864810 DOI: 10.21815/jde.017.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 03/09/2017] [Indexed: 01/02/2023]
Abstract
Dental graduates of 2040 will face new and complex challenges. If they are to meet these challenges, dental schools must develop a research and discovery mission that will equip graduates with the new knowledge required to function in a modern health care environment. The dental practitioner of 2040 will place greater emphasis on risk assessment, disease prevention, and health maintenance; and the emerging discipline of precision medicine and systems biology will revolutionize disease diagnosis and reveal new targeted therapies. The dental graduate of 2040 will be expected to function effectively in a collaborative, learning health care system and to understand the impact of health care policy on local, national, and global communities. Emerging scientific fields such as big data analytics, stem cell biology, tissue engineering, and advanced biomimetics will impact dental practice. Despite all the warning signs indicating how the changing scientific and heath care landscape will dramatically alter dental education and dental practice, dental schools have yet to reconsider their research and educational priorities and clinical practice objectives. Until dental schools and the practicing community come to grips with these challenges, this persistent attitude of complacency will likely be at the dental profession's peril. This article was written as part of the project "Advancing Dental Education in the 21st Century."
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Affiliation(s)
- Peter J Polverini
- Dr. Polverini is Jonathan Taft Distinguished University Professor of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry and Professor, Department of Pathology, University of Michigan Medical School; and Dr. Krebsbach is Dean and Professor, University of California, Los Angeles, School of Dentistry.
| | - Paul H Krebsbach
- Dr. Polverini is Jonathan Taft Distinguished University Professor of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry and Professor, Department of Pathology, University of Michigan Medical School; and Dr. Krebsbach is Dean and Professor, University of California, Los Angeles, School of Dentistry
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Simmons LA, Wolever RQ, Bechard EM, Snyderman R. Patient engagement as a risk factor in personalized health care: a systematic review of the literature on chronic disease. Genome Med 2014; 6:16. [PMID: 24571651 PMCID: PMC4064309 DOI: 10.1186/gm533] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 02/21/2014] [Indexed: 01/22/2023] Open
Abstract
Background The role of patient engagement as an important risk factor for healthcare outcomes has not been well established. The objective of this article was to systematically review the relationship between patient engagement and health outcomes in chronic disease to determine whether patient engagement should be quantified as an important risk factor in health risk appraisals to enhance the practice of personalized medicine. Methods A systematic review of prospective clinical trials conducted between January 1993 and December 2012 was performed. Articles were identified through a medical librarian-conducted multi-term search of Medline, Embase, and Cochrane databases. Additional studies were obtained from the references of meta-analyses and systematic reviews on hypertension, diabetes, and chronic care. Search terms included variations of the following: self-care, self-management, self-monitoring, (shared) decision-making, patient education, patient motivation, patient engagement, chronic disease, chronically ill, and randomized controlled trial. Studies were included only if they: (1) compared patient engagement interventions to an appropriate control among adults with chronic disease aged 18 years and older; (2) had minimum 3 months between pre- and post-intervention measurements; and (3) defined patient engagement as: (a) understanding the importance of taking an active role in one’s health and health care; (b) having the knowledge, skills, and confidence to manage health; and (c) using knowledge, skills and confidence to perform health-promoting behaviors. Three authors and two research assistants independently extracted data using predefined fields including quality metrics. Results We reviewed 543 abstracts to identify 10 trials that met full inclusion criteria, four of which had ‘high’ methodological quality (Jadad score ≥ 3). Diverse measurement of patient engagement prevented robust statistical analyses, so data were qualitatively described. Nine studies documented improvements in patient engagement. Five studies reported reduction in clinical markers of disease (for example HbA1C). All studies reported improvements in self-reported health status. Conclusions This review suggests patient engagement should be quantified as part of a comprehensive health risk appraisal given its apparent value in helping individuals to effectively self-manage chronic disease. Patient engagement measures should include assessment of the knowledge, confidence and skills to prevent and manage chronic disease, plus the behaviors to do so.
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Affiliation(s)
- Leigh Ann Simmons
- Current address: Duke University School of Nursing, DUMC Box 3322, Durham, NC 27710-3322, USA ; Center for Research on Prospective Health Care, Duke University Health System, Durham, NC 27710, USA
| | - Ruth Q Wolever
- Current address: Duke Integrative Medicine, DUMC Box 102904, Durham, NC 27710-2904, USA ; Department of Psychiatry and Behavioral Sciences, Duke School of Medicine, Durham, NC 27710-2904, USA
| | - Elizabeth M Bechard
- Current address: Duke Integrative Medicine, DUMC Box 102904, Durham, NC 27710-2904, USA
| | - Ralph Snyderman
- Center for Research on Prospective Health Care, Duke University Health System, Durham, NC 27710, USA ; Current address: Department of Medicine, DUMC Box 3059, Durham, NC 27710-3059, USA
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Abstract
Genomic technologies are reaching the point of being able to detect genetic variation in patients at high accuracy and reduced cost, offering the promise of fundamentally altering medicine. Still, although scientists and policy advisers grapple with how to interpret and how to handle the onslaught and ambiguity of genome-wide data, established and well-validated molecular technologies continue to have an important role, especially in regions of the world that have more limited access to next-generation sequencing capabilities. Here we review the range of methods currently available in a clinical setting as well as emerging approaches in clinical molecular diagnostics. In parallel, we outline implementation challenges that will be necessary to address to ensure the future of genetic medicine.
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Smith LL, Lake NH, Simmons LA, Perlman A, Wroth S, Wolever RQ. Integrative Health Coach Training: A Model for Shifting the Paradigm Toward Patient-centricity and Meeting New National Prevention Goals. Glob Adv Health Med 2013; 2:66-74. [PMID: 24416674 PMCID: PMC3833534 DOI: 10.7453/gahmj.2013.034] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To describe the evolution, training, and results of an emerging allied health profession skilled in eliciting sustainable health-related behavior change and charged with improving patient engagement. METHODS Through techniques sourced from humanistic and positive psychology, solution-focused and mindfulness-based therapies, and leadership coaching, Integrative Health Coaching (IHC) provides a mechanism to empower patients through various stages of learning and change. IHC also provides a method for the creation and implementation of forward-focused personalized health plans. RESULTS Clinical studies employing Duke University Integrative Medicine's model of IHC have demonstrated improvements in measures of diabetes and diabetes risk, weight management, and risk for cardiovascular disease and stroke. By supporting and enabling individuals in making major lifestyle changes for the improvement of their health, IHC carries the potential to reduce rates and morbidity of chronic disease and impact myriad aspects of healthcare. CONCLUSION As a model of educational and clinical innovation aimed at patient empowerment and lifestyle modification, IHC is aligned well with the tenets and goals of recently sanctioned federal healthcare reform, specifically the creation of the first National Prevention and Health Promotion Strategy. PRACTICE IMPLICATIONS IHC may allow greater patient-centricity while targeting the lifestyle-related chronic disease that lies at the heart of the current healthcare crisis.
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Affiliation(s)
- Linda L Smith
- Duke Integrative Medicine, Durham, North Carolina, United States
| | - Noelle H Lake
- Noelle Lake Coaching (private practice), Brooklyn, New York, United States
| | - Leigh Ann Simmons
- Duke Integrative Medicine, Duke University Health System and School of Nursing and Center for Research on Prospective Health Care, United States
| | - Adam Perlman
- Duke Integrative Medicine and Department of Medicine, Duke School of Medicine, United States
| | - Shelley Wroth
- Duke Integrative Medicine and Department of Obstetrics and Gynecology, Duke School of Medicine, United States
| | - Ruth Q Wolever
- Duke Integrative Medicine and Department of Psychiatry & Behavioral Sciences, Duke School of Medicine, United States
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Yang N, Ginsburg GS, Simmons LA. Personalized medicine in women's obesity prevention and treatment: implications for research, policy and practice. Obes Rev 2013; 14:145-61. [PMID: 23114034 DOI: 10.1111/j.1467-789x.2012.01048.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 08/30/2012] [Accepted: 08/30/2012] [Indexed: 12/20/2022]
Abstract
The prevalence of obesity in America has reached epidemic proportions, and obesity among women is particularly concerning. Severe obesity (body mass index ≥35 kg m(-2) ) is more prevalent in women than men. Further, women have sex-specific risk factors that must be considered when developing preventive and therapeutic interventions. This review presents personalized medicine as a dynamic approach to obesity prevention, management and treatment for women. First, we review obesity as a complex health issue, with contributing sex-specific, demographic, psychosocial, behavioural, environmental, epigenetic and genetic/genomic risk factors. Second, we present personalized medicine as a rapidly advancing field of health care that seeks to quantify these complex risk factors to develop more targeted and effective strategies that can improve disease management and/or better minimize an individual's likelihood of developing obesity. Third, we discuss how personalized medicine can be applied in a clinical setting with current and emerging tools, including health risk assessments, personalized health plans, and strategies for increasing patient engagement. Finally, we discuss the need for additional research, training and policy that can enhance the practice of personalized medicine in women's obesity, including further advancements in the '-omics' sciences, physician training in personalized medicine, and additional development and standardization of innovative targeted therapies and clinical tools.
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Affiliation(s)
- N Yang
- Duke Center for Research on Prospective Health Care, Duke University School of Medicine, Durham, North Carolina, USA
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Burnette R, Simmons LA, Snyderman R. Personalized health care as a pathway for the adoption of genomic medicine. J Pers Med 2012; 2:232-40. [PMID: 25562362 PMCID: PMC4251371 DOI: 10.3390/jpm2040232] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 10/30/2012] [Accepted: 11/01/2012] [Indexed: 11/16/2022] Open
Abstract
While the full promise of genomic medicine may be many years in the future, personalized health care (PHC) can begin solving important health care needs now and provide a framework for the adoption of genomic technologies as they are validated. PHC is a strategic approach to medicine that is individualized, predictive, preventive, and involves intense patient engagement. There is great need for more effective models of care as nearly half of Medicare patients age 65 and older have three or more preventable chronic conditions and account for 89% of Medicare’s growing expenditures. With its focus on reactive care, the current health care system is not designed to effectively prevent disease nor manage patients with multiple chronic conditions. PHC may be a solution for improving care for this population and therefore has been adopted as the delivery platform along with a new personalized health plan tool for 230 multi-morbid, homebound Medicare recipients in Durham, North Carolina who have been high utilizers of health care resources. PHC integrates available personalized health technologies, standards of care, and personalized health planning to serve as a model for rational health care delivery. Importantly, the PHC model of care will serve as a market for emerging predictive and personalized technologies to foster genomic medicine.
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Affiliation(s)
- Robin Burnette
- Duke Center for Research on Prospective Health Care, Duke University Medical Center, Durham 27701, NC, USA.
| | - Leigh Ann Simmons
- Duke Center for Research on Prospective Health Care, Duke University Medical Center, Durham 27701, NC, USA.
| | - Ralph Snyderman
- Duke Center for Research on Prospective Health Care, Duke University Medical Center, Durham 27701, NC, USA.
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Abstract
Healthcare reform must deal with the challenge of reducing the cost of care while embracing the opportunity to improve care delivery. Personalized medicine will be key to developing new care models. These models will provide coordinated and continuous care delivered by a team, with the individual patient as the central member of the team. Clinical effectiveness research will identify the best care models and reduce variation for populations of patients with a given disease. Personalized medicine will apply 'big science 'omics' with a systems biology approach to define disease networks, allowing us to add back appropriate variation in care for the individual. This effort will be enhanced by the electronic health record, which, combined with deep analytics, will capture detailed phenotypic data matched with the genotype. We are at the beginning of this journey and, despite a variety of technical, economic and societal hurdles, we cannot afford to fail.
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Affiliation(s)
- Steven D Shapiro
- University of Pittsburgh Medical Center & Department of Medicine, University of Pittsburgh School of Medicine, 600 Grant Street, Pittsburgh PA 15219, USA.
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Polverini PJ. A curriculum for the new dental practitioner: preparing dentists for a prospective oral health care environment. Am J Public Health 2012; 102:e1-3. [PMID: 22390456 PMCID: PMC3484004 DOI: 10.2105/ajph.2011.300505] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2012] [Indexed: 01/08/2023]
Abstract
The emerging concept of prospective health care would shift the focus of health care from disease management to disease prevention and health management. Dentistry has a unique opportunity to embrace this model of prospective and collaborative care and focus on the management of oral health. Academic dentistry must better prepare future dentists to succeed in this new health care environment by providing them with the scientific and technical knowledge required to understand and assess risk and practice disease prevention. Dental schools must consider creating career pathways for enabling future graduates to assume important leadership roles that will advance a prospective oral health care system.
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Affiliation(s)
- Peter J Polverini
- University of Michigan School of Dentistry, 1011 N University Ave, Ann Arbor, MI 48109-1078, USA.
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Simmons LA, Dinan MA, Robinson TJ, Snyderman R. Personalized medicine is more than genomic medicine: confusion over terminology impedes progress towards personalized healthcare. Per Med 2012; 9:85-91. [PMID: 29783292 DOI: 10.2217/pme.11.86] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Over the last decade, scientific discovery and technological advances have created great anticipation for capabilities to tailor individual medical decisions and provide personalized healthcare. Despite some advances, adoption has been sporadic and there remains a lack of consensus about what personalized healthcare actually means. This confusion has often resulted from the mistake of equating personalized medicine with genomic medicine, and thereby, attributing it as yet unfulfilled expectations of genomic medicine to the broader application of personalized medicine. The lack of a clear understanding of personalized medicine has limited its adoption within clinical delivery models. It is thus essential to reach a consensus regarding what personalized healthcare and its components mean. We propose that personalized healthcare is an approach to care that utilizes personalized medicine tools to deliver patient-centered, predictive care within the context of coordinated service delivery, and it is poised to improve healthcare delivery today.
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Affiliation(s)
- Leigh Ann Simmons
- Center for Research on Prospective Health Care, Department of Medicine, Duke University, 3475 Erwin Road, Aesthetics Room 271, Durham, NC 27705, USA
| | - Michaela Ann Dinan
- Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC 27705, USA
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Abstract
Personalized medicine is a broad and rapidly advancing field of health care that is informed by each person's unique clinical, genetic, genomic, and environmental information. Personalized medicine depends on multidisciplinary health care teams and integrated technologies (e.g., clinical decision support) to utilize our molecular understanding of disease in order to optimize preventive health care strategies. Human genome information now allows providers to create optimized care plans at every stage of a disease, shifting the focus from reactive to preventive health care. The further integration of personalized medicine into the clinical workflow requires overcoming several barriers in education, accessibility, regulation, and reimbursement. This review focuses on providing a comprehensive understanding of personalized medicine, from scientific discovery at the laboratory bench to integration of these novel ways of understanding human biology at the bedside.
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Affiliation(s)
- Isaac S Chan
- Center for Genomic Medicine, Institute for Genome Sciences & Policy, Duke University, Durham, North Carolina 27708, USA
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