A Clinical Perspective: maximising patient experience in the healthcare environment
Beñat Zubeltzu is a clinician who specialises in internal medicine, regularly dealing with multi-pathological patients both as inpatients and outpatients. Heart failure is the most common pathology among them and in recent years he has worked with the pioneering "chronic patient" team at Donostia hospital (Gipuzkoa, Spain), providing integrated solutions and alternative pathways adapted to their needs. Beñat joined the ADLIFE project where he can now bring this experience to bear and contribute to the clinical orientation of the ADLIFE toolbox.
The ADLIFE platform provides an environment that supports integrated care for the heart failure patient. But how does a patient feel in an integrated healthcare environment?
Traditionally, care has been fragmented, leading people with heart failure to have multiple healthcare contacts with professionals, some involving admissions or visits to the emergency department. They have found themselves in situations where professionals demonstrate differing judgements and poor internal communication. These scenarios often result in contradictory instructions and messages to people with heart failure, leading to feelings of helplessness and frustration.
ADLIFE will try to minimise all these negative aspects so that people with heart disease can move through the healthcare system in a more user-friendly way. Recommendations to patients are made in a shared digital environment, easily accessible to patients and professionals. They will be able to view recommended tasks both in terms of lifestyle recommendations (diet, exercise...) and pharmacological prescriptions, avoiding duplication and ensuring that the drugs are reconciled between the professionals involved. In addition, the patient will have a direct communication channel with his or her healthcare team through their Patient Empowerment Platform.
From the clinicians' point of view, ADLIFE provides a very interesting tool to offer recommendations in line with evidence-based medicine. ADLIFE does not function as a simple platform for uploading information, but is accompanied by an intelligent decision-making tool that I believe will give us confidence in what we do. In my clinical practice, one of the problematic points when making decisions is to adjust a recommendation that is good for heart failure, but at the same time respectful of the other diseases that a given patient has (so that it does not affect the function of their kidneys or their bronchial function for example). NICE clinical guidelines have been implemented in ADLIFE to dynamically assist clinician decision making in a safe and satisfactory way. It will consider the individual characteristics of our patient and their co-morbidities. In this sense, an immense amount of work has been done in the implementation of the heart failure guideline, but reconciled with the guidelines for the most prevalent comorbidities (for example, diabetes, COPD and chronic renal failure).
Expectations are high and will have to be tested with real-life patients in the pilot over the coming months. I very much looking forward to seeing how this tool works in real life and whether it improves the outcomes we have set out to achieve, both in terms of hospital admissions and in the quality of life for people with heart failure.
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