Public Reports: Quality of care - details
e-Quality in e-Health -
Stakeholders' reflections on addressing e-health challenges at the European
level. Health First Europe, 2011
This document brings together a series of papers covering:
- Citizens’ E-Health
- E-Health and
- E-Health in Practice
- E-Health and
"In Chapter 1, we understand why
health infor mation should be made
available directly to patients and why
electronic information is the best
means of information sharing. A few
important aspects related to these issues
are laid down: trustworthiness and
comprehensibility. Information should be
available to patients in all languages so
that when faced with such information,
all patients can have the opportunity to
understand it with the maximum level of
responsibility and data security.
Moreover, another feature of modern
technologies is technical interoperability,
which should be seen as a future ‘must
do’ so that information becomes not
only mobile but accessible. In light of this,
e-health should bring with it the simplification
of administrative procedures and should
be a source of education and evaluation
for the medical profession, facilitating the
patient-doctor relationship. In this sense, the two major problems
identified in Chapter 1, data protection
and interoperability raise a common set
of questions that need to be answered
in the future: what type of legislation is
needed to ensure simultaneously data
protection and interoperability, what
funding should be allocated for this and
how can we bypass connectivity issues?
"Chapter 2 tries to answer just that,
explaining why we are so sure that
e-health is a tool that empowers
citizens. It will deliver key services such
as rapid access to medical records,
making it possible that a chronic disease
could even be remotely monitored or
that 5 million yearly prescription errors
could be avoided. Thus, it improves the
management of healthcare and what is
essential to remember is that we know
it works. A similar program has already
been implemented in Sweden and people
there could tangibly feel that it delivered
on its promises. In addition, Malta,
Germany, Slovenia and Slovakia have
developed ID cards where health and
illness information is accessibly stored.
"Chapter 3 explains two aspects of
ICT technologies: that projects such
as the Virtual Physiological Human were
a success and that in spite of being an
advanced technological tool e-health is
still in its infancy and has even greater
potential for innovation. Hence, this
chapter explains in specific terms what
e-health does and most importantly what
it could do in practice.
"Chapter 4 [talks] of present and
future challenges that affect the medical
profession and overall, the EU and its
patients. Two articles both recognize
that under the pressure of an ageing
population phenomenon, healthcare
services need the digitisation that could
be brought by e-health investments.
In this sense, the main points voiced
refer to training professionals in the best
way possible, facilitating for them both
hardware and software material."
Department of Health. High quality care for all: NHS Next Stage Review final report.
The report "sets out the background, overarching vision and next steps [...] for the future of the NHS".
Priorities described in the report include:
- "Stronger and more proactive focus on public health and helping people stay healthy, with more support to tackle childhood obesity, alcohol misuse and smoking.
- Clearer and simpler routes to finding the right care 24/7.
- As much care as possible delivered closer to home, with treatment of major trauma, heart attack and stroke care within specialised centres.
- Improving the lives of those with long-term conditions by ensuring that patients can take a full part in their own treatment and care, including the use of health plans and more assistive technology to help people manage their own conditions.
- Improving patient experience by ensuring privacy, dignity and cleanliness, and by providing more information and choice."
Plan National pour la Promotion de la Qualité
"Dans sa session du 15 avril 2005, le gouvernement en Conseil a adopté le Plan National pour la Promotion de la Qualité qui constitue une démarche globale pour l’amélioration de la qualité, inévitable pour consolider la place économique et financière d’un pays.
Le plan national consiste en un premier plan d’action qui prévoit la mise en place de certaines mesures servant à augmenter le niveau de qualité dans les différents domaines, notamment le secteur agricole, viticole, horticole et alimentaire, le secteur hospitalier, le secteur personnes âgées et accueil gérontologique, le secteur des entreprises, le secteur de l'éducation nationale, le secteur métrologie, le secteur transports et le secteur de l'administration publique.
The Luxembourg National Plan for the Promotion of Quality, published in April 2005, deals with a range range of domains. Chapter 7 (pp12-16) deals specifically with Le secteur hospitalier
- the hospital sector and plans for the period 2005-6.
Chapter 8 is focused on services for elderly people - Le secteur personnes âgées, accueil gérontologique.
Caminando hacia la excelencia: II Plan de Calidad del Sistema Sanitario
Público de Andalucía 2005-2008.
| Crossing the Quality Chasm
Corrigan JM, Donaldson MS, Kohn LT et al. Crossing the Quality Chasm. A New Health System for the 21st Century. Washington, DC: Institute of Medicine, National Academy of Sciences, National Academies Press; 2001.
The report assigns much of the blame for medical errors (which, as 'To Err is Human' suggested, kill up
to 98,000 people pa. in the USA) to shortcomings in the healthcare system and
makes proposals for its redesign.
The report "defines six aims: care should be safe, effective, patient-centered, timely, efficient and equitable"
–and specifies 10 rules for care delivery redesign.
- Care based on continuous healing relationships--care whenever its needed, not just through face to face visits
- Customisation based on patient needs and values
- The patient as the source of control
- Shared knowledge and free flow of information
- Evidence-based decision making
- Safety as a system property
- Transparency: all information available, including the system’s performance on safety, evidence based practice, and patient satisfaction
- Anticipation of needs
- Continuous decrease in waste
- Co-operation among clinicians
Basic premise: "The fundamental aim of modern
healthcare is to make the best match
between patient need (both
recognised and unrecognised) and
expectations, and to deliver care in a
timely, efficient manner that achieves
maximum benefit for the least cost"
| Envisioning the National Health Care Quality Report
Committee on the National Quality Report on Health Care Delivery Margarita P.
Hurtado, Elaine K. Swift, and Janet M. Corrigan, Editors.
Envisioning the National Health Care Quality Report.
Board on Health Care Services, Institute Of Medicine,
National Academy Press, Washington, D.C., March 2001
"At the request of the Agency for Healthcare Research
and Quality (AHRQ), the IOM committee provides a vision
of the design and contents of a report on the quality
of the health care delivery in the United States mandated
by Congress. The IOM committee report includes 10 recommendations
and specific chapters on: defining the framework and types
of measures that should be included; selecting measures;
evaluating data sources; and designing the National Health
Care Quality Report for specific audiences. " [IOM]
|Entry on OpenClinical: 2003|
Last main update: 10 October 2009