The Active Patient: Paradigm Shift in the Continuum of Care
Dr. Michael Dahlweid
As Dedalus, we have over forty countries with our digital healthcare solutions. Regardless of the individual characteristics of each healthcare system, we believe that the respective ecosystems are undergoing massive change. In addition to generally known factors such as the aging population, the increasing frequency of chronic diseases, and an overload and thinning out of caring nurses and doctors, we see more active, connected, and engaged patients.
The healthcare system is under pressure.
The Corona pandemic dramatically impacted every aspect of our lives: from relationships to travel, from work practices to personal and family life. In the health sector, the systemic weaknesses of health care delivery became abundantly clear: sectoral isolation, manual efforts to link patient data, non-existent interactions between health and social care providers, to name a few. All of this comes at the expense of health professionals through exponentially higher manual efforts and leads to demonstrable shortfalls in patient care.
The face of the patient in transition
Fortunately, however, many patients are becoming engaged, active co-creators of their care, refusing to be placed “at the center of a system” that sees them only as passive subjects. Evidence shows that an informed, active patient achieves better clinical outcomes and that overall patient engagement can improve service delivery and health care governance and help reduce health care costs.
Active patients are anything but “patient” and no longer accept the traditional “patriarchal cultural model” between them and their doctors: the active patient wants to take charge of their health and expects healthcare providers to support and engage with them across the entire spectrum of healthcare. Modern, even virtual methods of communication are accepted and in demand. A recent study from Germany and Austria, for example, shows that over 90% of patients who had video consultations with doctors would repeat them and that over 80% of these patients felt more able to make a self-determined, active decision when they compared their telemedicine consultation with a conventional on-site consultation.
Health systems need to redefine their approach in line with this new mindset, moving from a “patient-centered” to a “patient-active” view.
Multiple factors-genomics predetermine lifelong conditions, metabolomics, environmental factors, social determinants of health-and require the engagement of health professionals from various disciplines to work across the continuum of care, educating and collaborating with patients so that they become active participants in their care.
Chronic vs. acute
This “patient-active” approach is fundamental for treating chronic conditions as opposed to acute illnesses. Acute diseases are usually treated by specialists who can intervene quickly. A person breaks a bone and needs surgery, and they see a specialized orthopedist – for knees, for shoulders, for ankles, etc. – The person has surgery and then receives rehabilitation. Apart from rehab, the patient’s role is relatively passive, and they are expected to return to their everyday life.
What does this continuum of care look like?
To better serve and support patients today and in the future, healthcare providers must engage them early.
- Focus on prevention and prehabilitation: In contrast to more passive, patient-centered care, this means equipping people with information about healthy lifestyles, nutrition, wellbeing, as well as ways to avoid illness, etc., and, in the case of elective procedures, for example, preparing for prehabilitation before therapeutic intervention.
- Focus on early detection: actively asking patients to participate in screening and similar programs, for example, will change the course of treatment for diseases such as cancer, leading to better outcomes for patients and lower costs for the healthcare system.
- Networked diagnostics: Thanks to improved tests in pathology and radiology, as well as advances in genomics and other “-omics,” early diagnosis is now more straightforward, allowing patients to be treated earlier with precision medicine tailored to the individual based on predicted response and risk. This, in turn, calls for an active patient role.
- Active decision-making: The patient treatment requires careful consideration of treatment options – whether drug, radio-therapeutic, surgical, immunological, rehabilitative, or otherwise. These decisions must have active and engaged patient support, resulting in significantly better patient outcomes.
- Rehabilitation: An enormously important aspect for aging populations to enable people to remain independent as long as possible. The more actively patients participate, and the earlier and more extensively the measures are requested and implemented, the better the results.
- Follow-up phase: this involves close, home-based monitoring to avoid acute episodes of chronic illness, keeping people out of the hospital, and letting them actively self-manage their conditions.
The Dedalus Advantage
As Dedalus, we do our part by providing digital tools that improve everyone’s engagement with healthcare services and put the active patient at the center.
For example, in the German-speaking area and in the context of Orbis and DeepUnity, we will launch the product “PatientXCareSuite” in Q2 2022, entirely based on the involvement of the active patient.
Furthermore, Dedalus has many projects with regional healthcare organizations. In the Puglia region (population five million) in Italy, all chronically ill patients are integrated into a fully networked, cloud-based system including all aspects of HomeCare, enabling close coordination between all stakeholders. In Bologna (Italy) region, two million people are seamlessly supported by an integrated, app- and cloud-based tool to actively influence complicated pre- and post-hospital care aspects between hospitals, care, and social service providers.
In England, North Staffordshire Combined Healthcare NHS Trust launched a new Dedalus platform for engaging and referring young people to mental health services to enable access and active co-creation of the needs of students, teachers, parents, and carers.
In the UK as well as in Ireland, France, and Italy, we enable patient-individualized, active, and direct cloud-based booking of medical services, examinations, and appointments for hospitals, diagnostic centers, polyclinics, as well as for the patient’s home, which we can combine with report feedback and active report exchange. This leads to entirely new possibilities of active control by the patient, who can, for example, have blood samples for laboratory tests taken at home.
In Belgium, more than half of the population already have individualized access to their medical images and findings, utilizing our cloud-based medical imaging solution – a solution we offer in a further twelve countries.
In Denmark, the national healthcare system has implemented a prehospital platform from Dedalus that ensures seamless communication and real-time transmission of prehospital data from patients, their caregivers, ambulances that may be deployed, and hospital departments communicating with patients’ families.
The Corona pandemic, in particular, has driven healthcare organizations around the world to accelerate their digital transformation processes. To succeed, we need to change our approach to patients as an industry, and we need to actively involve them in shaping and making them part of their own healthcare experience.
This is what we stand for as Dedalus.
Dr. Michael Dahlweid
Dedalus Group Product & Clinical Officer and Member of the Group Executive Committee
Michael is a recognized HealthCare leader in client-engaging, strategic, and operational global roles. Today at Dedalus, Michael‘s dedication is to drive the organization to create the best tools for digital medicine across the globe, and to advocate for their impactful utilization for active patients and healthcare providers alike.