The paper discusses possible improvement of healthcare through extension of its organizational model and better utilization of medical information systems. A brief review of ‘classical’ healthcare informatization tools is given with their relation to the steps of healthcare workflow that they intend to optimize. All consumers of healthcare are divided in four target audiences based on their needs in care and health preservation. Concepts of ‘health continuum’ and ‘continuum of care’ are discussed, with special focus on the parts of care continuum where informatization is currently lacking. The underlying reasons for such gaps are limitations of the prevailing healthcare organizational model. The current biomedical diagnosis-centric model of care is compared with biopsychosocial person-centric model. Further progress of healthcare through wider application of biopsychosocial model should expand opportunities for informatization.
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2. Fuller J. The new medical model: a renewed challenge for biomedicine. CMAJ. 2017; 189(17): E640-E641. doi:10.1503/cmaj.160627.
3. Wade D. Rehabilitation – a new approach. Overview and Part One: the problems. Clin Rehabil. 2015; 29(11): 1041–1050. doi:10.1177/0269215515601174.
4. Engel G.L. The need for a new medical model: a challenge for biomedicine. Science 1977; 196: 129–36.
5. Farre A., Rapley T. The New Old (and Old New) Medical Model: Four Decades Navigating the Biomedical and Psychosocial Understandings of Health and Illness. Healthcare (Basel). 2017; 5(4): 88. doi:10.3390/healthcare5040088.
6. Wade D. Rehabilitation – a new approach. Part four: a new paradigm, and its implications. Clin Rehabil. 2016; 30(2): 109–118. doi:10.1177/0269215515601177.
7. Perhov V.I., Lyucko V.V. Makroekonomicheskie raskhody na zdravoohranenie v Rossii i za rubezhom. Sovremennye problemy zdravoohraneniya i medicinskoj statistiki. 2019, 2: 334–345. ( In Russ. ). doi:10.24411/2312 2935 2019 00047.
8. Travis J. W., Ryan R. S. Wellness Workbook : How to Achieve Enduring Health and Vitality. Berkeley , Calif : Ten Speed Press, 1988 , 237p.
9. Egger G., Stevens J., Binns A., Morgan B. Psychosocial Determinants of Chronic Disease: Implications for Lifestyle Medicine. Am J Lifestyle Med. 2019; 13(6): 526–532. doi: 10.1177/1559827619845335.
10. Drapkina O.M. I dr. Organizaciya provedeniya profilakticheskogo medicinskogo osmotra i dispanserizacii opredelennyh grupp vzroslogo naseleniya. Metodicheskie rekomendacii po prakticheskoj realizacii prikaza Minzdrava Rossii ot 13 marta 2019 g. № 124n «Ob utverzhdenii poryadka provedeniya profilakticheskogo medicinskogo osmotra i dispanserizacii opredelennyh grupp vzroslogo naseleniya». M., 2019. 165 р. ( In Russ. ).
11. Fortin M., Chouinard M.C., Diallo B.B., Bouhali T. Integration of chronic disease prevention and management services into primary care (PR1MaC): findings from an embedded qualitative study. BMC Fam Pract. 2019; 20(1): 7. doi:10.1186/s12875–018–0898-z.
12. Prochaska J.O., Norcross J.C., DiClemente C.O. Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward. Harper Collins, New York, 1995.
13. Fogg B.J. Tiny habits: the small changes that change everything. Boston: H oughton Mifflin Harcourt, 2019.
14. Sagner M., McNeil A., Puska P , et al. The P4 Health Spectrum – A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan. Prog Cardiovasc Dis. 2017; 59(5): 506–521. doi:10.1016/j.pcad.2016.08.002.
15. Evashwick C. Creating the continuum of care. Health Matrix. 1989; 7(1): 30–39.
16. Haggerty J.L., Reid R.J., Freeman G.K., Starfield B.H., Adair C.E., McKendry R. Continuity of care: a multidisciplinary review. BMJ. 2003; 327(7425): 1219–1221. doi:10.1136/bmj.327.7425.1219.
17. McNabney M.K., Willging P.R., Fried L.P., Durso S.C. The “continuum of care” for older adults: design and evaluation of an educational series. J Am Geriatr Soc. 2009; 57(6): 1088–1095. doi:10.1111/j.1532–5415.2009.02275.x.
18. Jones D.S. (ed.) Textbook of Functional Medicine. 3rd edition. Institute for Functional Medicine , Gig Harbor, WA, 2010. 1096pp.
19. Flores M., Glusman G., Brogaard K., Price N.D., Hood L. P4 medicine: how systems medicine will transform the healthcare sector and society. Per Med. 2013; 10(6): 565–576. doi:10.2217/pme.13.57.
20. Santana M.J., Manalili K., Jolley R.J., Zelinsky S., Quan H., Lu M. How to practice person-centred care: A conceptual framework. Health Expect. 2018; 21(2): 429–440. doi : 10.1111/hex.12640.
21. Stolee P., Steeves B., Glenny C., Filsinger S. The use of electronic health information systems in home care: facilitators and barriers. Home Healthc Nurse. 2010; 28(3): 167–181. doi:10.1097/01.NHH.0000369769.32246.92.
22. Zakroeva A. G. Strategiya vedeniya pacientov sosnovnymi hronicheskimi neinfekcionnymi zabolevaniyami iih faktorami riska (sistemnyj analiz problemy iobosnovanie biopsihosocial'nogo podhoda). Avtoref. Diss. d. m. n. 2015, 48 р. ( In Russ. ).
23. Mills K.T., Bundy J.D., Kelly T.N. et al. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation. 2016; 134(6): 441–450. doi:10.1161/CIRCULATIONAHA.115.018912.
24. Gupta A., Ravaliya V., Mishra D. et al. Assessment of knowledge, attitude, and behavior about the disease process and physiotherapy management in patients with chronic obstructive pulmonary disease: A qualitative study. J Educ Health Promot. 2019; 8: 15. doi:10.4103/jehp.jehp_209_18.
25. Belyshev D.V., Guliev Y a.I., Komarov A.N., Martyushev-Poklad A.V., Miheev A.E., Panteleev S.N., Romanov A.I. Stacionar-zameshchayushchie tekhnologii v cifrovoj ekosisteme upravleniya zdorov'em. Vrach i informacionnye tekhnologii. 2019 (4): 13–20. (In Russ.). doi : 10.24412/FioeCft6t1I.
For citation
Martyushev - Poklad A. V., Yankevich D.S., Panteleev S.N., Prya nikov I.V., Guliev Y.I. Healthcare information systems and organizational model of care: current situation and opportunities for progress. Medical doctor and information technology. 2020; S 5 : 6-16. (In Russ.). doi: 10.37690/1811-0193-2020-5-6-16.
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