von Tottleben Malte, Grinyer Katie, Arfa Ali, Traore Lamine, Verdoy Dolores, Lim Choi Keung Sarah N, Larranaga Igor, Jaulent Marie-Christine, De Manuel Keenoy Esteban, Lilja Mikael, Beach Marie, Marguerie Christopher, Yuksel Mustafa, Laleci Erturkmen Gokce Banu, Klein Gunnar O, Lindman Pontus, Mar Javier, Kalra Dipak, Arvanitis Theodoros N
empirica Gesellschaft für Kommunikations- und Technologieforschung mbH, Bonn, Germany.
Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Inserm, Sorbonne Université, Université Paris 13, Paris, France.
JMIR Res Protoc. 2022 Jul 13;11(7):e21994. doi: 10.2196/21994.
There is an increasing need to organize the care around the patient and not the disease, while considering the complex realities of multiple physical and psychosocial conditions, and polypharmacy. Integrated patient-centered care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced information and communication technology solutions for semiautomated clinical decision support.
The Collaborative Care and Cure Cloud project (C3-Cloud) has developed 2 collaborative computer platforms for patients and members of the multidisciplinary team (MDT) and deployed these in 3 different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients with 2 or more chronic conditions (diabetes mellitus type 2, heart failure, kidney failure, depression), their informal caregivers, health care professionals, and, to some extent, health care systems.
This paper describes the protocol for conducting an evaluation of user experience, acceptability, and usefulness of the platforms. For this, 2 "testing and evaluation" phases have been defined, involving multiple qualitative methods (focus groups and surveys) and advanced impact modeling (predictive modeling and cost-benefit analysis). Patients and health care professionals were identified and recruited from 3 partnering regions in Spain, Sweden, and the United Kingdom via electronic health record screening.
The technology trial in this 4-year funded project (2016-2020) concluded in April 2020. The pilot technology trial for evaluation phases 3 and 4 was launched in November 2019 and carried out until April 2020. Data collection for these phases is completed with promising results on platform acceptance and socioeconomic impact. We believe that the phased, iterative approach taken is useful as it involves relevant stakeholders at crucial stages in the platform development and allows for a sound user acceptance assessment of the final product.
Patients with multiple chronic conditions often experience shortcomings in the care they receive. It is hoped that personalized care plan platforms for patients and collaboration platforms for members of MDTs can help tackle the specific challenges of clinical guideline reconciliation for patients with multimorbidity and improve the management of polypharmacy. The initial evaluative phases have indicated promising results of platform usability. Results of phases 3 and 4 were methodologically useful, yet limited due to the COVID-19 pandemic.
ClinicalTrials.gov NCT03834207; https://clinicaltrials.gov/ct2/show/NCT03834207.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/21994.
在考虑多种身体和心理社会状况以及多重用药的复杂现实的同时，围绕患者而非疾病组织护理的需求日益增加。已经为患者和临床医生开发了以患者为中心的综合护理交付平台。这些平台可以提供一种很有前景的方式，通过增强的信息和通信技术解决方案实现半自动化临床决策支持，从而营造一个协作环境，改善为患者提供的综合护理。
协作护理与治愈云项目（C3-Cloud）为患者和多学科团队（MDT）成员开发了2个协作计算机平台，并在3种不同的欧洲环境中进行了部署。本研究的目的是对这些平台进行试点测试，并评估它们对患有2种或更多慢性疾病（2型糖尿病、心力衰竭、肾衰竭、抑郁症）的患者、他们的非正式护理人员、医疗保健专业人员以及在一定程度上对医疗保健系统的影响。
本文描述了对平台的用户体验、可接受性和有用性进行评估的方案。为此，定义了2个“测试与评估”阶段，涉及多种定性方法（焦点小组和调查）以及先进的影响建模（预测建模和成本效益分析）。通过电子健康记录筛查，从西班牙、瑞典和英国的3个合作地区识别并招募了患者和医疗保健专业人员。
这个为期4年的资助项目（2016 - 2020年）中的技术试验于2020年4月结束。第3和第4阶段评估的试点技术试验于2019年11月启动，并持续到2020年4月。这些阶段的数据收集已完成，在平台接受度和社会经济影响方面取得了令人鼓舞的结果。我们认为所采用的分阶段、迭代方法很有用，因为它在平台开发的关键阶段让相关利益相关者参与进来，并允许对最终产品进行合理的用户接受度评估。
患有多种慢性疾病的患者在接受护理时常常存在不足。希望针对患者的个性化护理计划平台和针对MDT成员的协作平台能够帮助应对患有多种疾病患者在临床指南协调方面的具体挑战，并改善多重用药的管理。最初的评估阶段显示了平台可用性的令人鼓舞的结果。第3和第4阶段的结果在方法上是有用的，但由于新冠疫情而受到限制。
ClinicalTrials.gov NCT03834207；https://clinicaltrials.gov/ct2/show/NCT03834207。
国际注册报告识别码（IRRID）：RR1-10.2196/21994。
