Department of Strategic ICT, Helse Vest IKT, Bergen, Norway; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
Int J Med Inform. 2024 Dec;192:105623. doi: 10.1016/j.ijmedinf.2024.105623. Epub 2024 Sep 19.
Despite the recognized benefits of integrating patient perspectives into healthcare design and clinical decision support, theoretical approaches and standardized methods are lacking. Various strategies, such as developing pathways, have evolved to address these challenges. Previous research emphasized the need for a framework for care pathways that includes theoretical principles, extensive user involvement, and data from electronic health records to bridge the gap between different fields and disciplines. Standardizing the representation of the patient perspective could facilitate its sharing across healthcare organizations and domains and its integration into journal systems, shifting the balance of power from the provider to the patient.
This study aims to 1) Identify research approaches taken to develop patient-centred, integrated, care pathways supported by electronic health records 2) Propose a socio-technical framework for designing patient-centred care pathways across multiple healthcare levels that integrates the voice of the patient with the knowledge of the care provider and technological perspectives.
This study conducted a scoping review following the Joanna Briggs Institute guidelines and PRISMA-ScR protocol. The databases PubMed, Scopus, Web of Science, ProQuest, IEEE, and Google Scholar were searched using a key term search strategy including variations of patient-centred, integrated care, pathway, framework and model to identify relevant studies. Eligible articles included peer-reviewed literature documenting methodologies for mapping patient-centred, integrated care pathways in healthcare service design.
This review summarizes the application of care pathway modelling practices across various areas of healthcare innovation. The search resulted in 410 studies, with 16 articles included after the full review and grey literature search.
Our research illustrated incorporating patient perspectives into modelling care pathways and healthcare service design. Regardless of the medical domain, our methodology proposes an approach for modelling patient-centred, integrated care pathways across the care continuum, including using electronic health records to support the pathways.
尽管将患者观点融入医疗保健设计和临床决策支持中已被广泛认可，但目前仍缺乏相关的理论方法和标准化方法。为了应对这些挑战，各种策略（如制定路径）应运而生。先前的研究强调需要开发一种包含理论原则、广泛的用户参与以及电子健康记录数据的护理路径框架，以弥合不同领域和学科之间的差距。标准化患者观点的表示形式可以促进其在医疗保健组织和领域之间的共享，并将其整合到期刊系统中，从而将权力从提供者转移到患者。
本研究旨在：1）确定用于开发基于电子健康记录的以患者为中心、整合型护理路径的研究方法；2）提出一种社会技术框架，用于设计跨多个医疗保健层级的以患者为中心的护理路径，将患者的声音与护理提供者的知识和技术观点相结合。
本研究按照乔安娜·布里格斯研究所指南和 PRISMA-ScR 方案进行了范围综述。使用包括以患者为中心、整合型护理、路径、框架和模型等变体的关键词搜索策略，在 PubMed、Scopus、Web of Science、ProQuest、IEEE 和 Google Scholar 等数据库中进行了搜索，以确定相关研究。符合条件的文章包括记录了在医疗保健服务设计中以患者为中心、整合型护理路径映射方法的同行评审文献。
本综述总结了护理路径建模实践在医疗保健创新各个领域的应用。搜索共产生了 410 项研究，经过全文审查和灰色文献搜索后，纳入了 16 篇文章。
我们的研究表明，将患者观点纳入到路径建模和医疗保健服务设计中。无论医疗领域如何，我们的方法都提出了一种跨护理连续体建模以患者为中心、整合型护理路径的方法，包括使用电子健康记录来支持这些路径。
