Computerized Decision Support Systems for Multimorbidity Care: An Urgent Call for Research and Development

Background

Advances in preventative and curative medicine as well as increasing life expectancy in the developed world have contributed to increasing multimorbidity (Smith et al., 2010). For example, an extensive cross-sectional study which extracted data on 40 morbidities from a database of 1,751,841 people registered with 314 medical practices in Scotland found that 42.2% of all patients had one or more morbidities and 23.2% were multimorbid (Barnett et al., 2012). Indeed, healthcare globally is faced with the need to cope with rising costs, aging populations and chronic disease (Kenning et al., 2013; Wills, Sarnikar, El-Gayar, & Deokar, 2010). In a study of 99,997 patients across 182 general practices in England, the majority of consultations were found to involve patients with multimorbidity (Salisbury, Johnson, Purdy, Valderas, & Montgomery, 2011).

Patients with multimorbidity often have frequent healthcare visits and frequent hospital admissions with enormous costs for the individuals and for the healthcare provider involved (C. M. Boyd et al., 2005). The healthcare costs for individuals with at least 3 chronic diseases accounted for 89% of Medicare’s annual budget in the US (Anderson & Horvath, 2004). The treatment of chronic illness patients in Europe was estimated to account for 70-80% of health care expenses in countries such as Denmark and comprise 8 of the top 11 causes of hospital admission in the UK (WHO, 2006).