Portal Technologies for Patient-centred Integrated Care

Integrated care pathways (ICP) are increasingly used in clinical settings to provide more effective care to patients. ICPs form part of local working agreements to assist co-ordination of multi-disciplinary teams to deliver evidence-based care plans to individual patients. They also document the expected progress of specific patient groups as part of clinical records. To anticipate increased use of ICPs, we have developed Healthcare@Home, a research-phase demonstrator for improving integration of information along the patient path. Healthcare@Home includes support for at-home, in-clinic and mobile wireless sensor devices feeding patient-proximal data hubs, timeline-based physiological trend analysis, data aggregation/dashboarding and individualised risk stratification. These and other decision support tools are embedded in portal designs supporting ‘end-to-end’ workflows as focused by the composite needs of a National Service Framework (NSF) for patients with diabetes. Healthcare@Home thus represents a scaleable, extensible personalised healthcare information system driven directly from national policy on disease early detection and prevention. Individual portlets have been mapped to stages in the ICP. The portal technologies employed, running on PCs, mobile phones or TVs are capable of highly cost-effective ‘end-to-end, anywhere-to-anywhere’ information integration.