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患者在未来医疗环境中的新角色。

The new role of patients in future health settings.

作者信息

Ruotsalainen Pekka, Blobel Bernd

机构信息

School of Information Sciences, University of Tampere, Finland.

Medical Faculty, University of Regensburg, Germany.

出版信息

Stud Health Technol Inform. 2015;211:71-8.

Abstract

Health is wide concept covering a person's physical, mental and social well-being. Traditionally, regulated healthcare has been the main source for curative and preventive service offered to patients. Healthcare is in transition, however. Paradigms such as patient empowerment and patient in the centre as well as in-home care service are changing processes and locations healthcare services are offered. Parallel to healthcare, new service models such as pHealth, ubiquitous healthcare, and digital medicine are developing. In the near future, technology enables the creation of a personal digital health dossier (e.g. digital patient and virtual patient model) for any individual. This dossier is stored and used in the unsecure information space. This all means that the traditional paternalistic patient model where patient is a passive object for regulated healthcare services will not work in future pHealth and digital health anymore. Instead, the new patient role (e.g. pHealth user or health consumer role) is dynamic, context-aware and participatory. The pHealth user can also have many roles at the same time, such as the role of informed chooser, decision maker, and personal health coordinator. This requires that the pHealth user can make information-based meaningful decisions before starting to use health services, and that he or she can trust on service providers by having evidence-based and reliable information about the quality and health impact of the services offered. A big challenge is that pHealth and digital health take place in unsecure information space where current healthcare specific laws, regulations, and medical ethics are insufficient to guarantee users' autonomy and privacy as well as the application of fair information and ethical principles when processing personal health information. A new ethical, legal and technical framework is needed. One of the prerequisites successful pHealth and digital health has to meet is the possibility to create information based on trustworthy relationship between service user and service providers. Furthermore, a trusted information platform is inevitable.

摘要

健康是一个广泛的概念,涵盖了一个人的身体、心理和社会福祉。传统上,规范的医疗保健一直是为患者提供治疗和预防服务的主要来源。然而,医疗保健正在转型。诸如患者赋权、以患者为中心以及家庭护理服务等范式正在改变医疗服务的提供流程和地点。与医疗保健并行,诸如移动健康、泛在医疗和数字医学等新的服务模式正在发展。在不久的将来,技术将能够为任何个人创建个人数字健康档案(例如数字患者和虚拟患者模型)。这个档案存储在不安全的信息空间中并被使用。这一切都意味着,传统的家长式患者模式,即患者是规范医疗服务的被动对象,在未来的移动健康和数字健康中将不再适用。相反,新的患者角色(例如移动健康用户或健康消费者角色)是动态的、情境感知的和参与性的。移动健康用户同时还可以扮演许多角色,例如明智的选择者、决策者和个人健康协调员。这就要求移动健康用户在开始使用健康服务之前能够基于信息做出有意义的决策,并且他或她能够通过获得关于所提供服务的质量和健康影响的循证且可靠的信息来信任服务提供者。一个巨大的挑战是,移动健康和数字健康发生在不安全的信息空间中,在这个空间里,当前特定于医疗保健的法律法规和医学伦理不足以保障用户的自主权和隐私,以及在处理个人健康信息时公平信息和伦理原则的应用。需要一个新的伦理、法律和技术框架。成功的移动健康和数字健康必须满足的前提条件之一是有可能基于服务用户和服务提供者之间的可信赖关系创建信息。此外,一个可信的信息平台是必不可少的。

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