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

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

Audrey Grace (University College Cork, Ireland), John O'Donoghue (Imperial College, UK), Carolanne Mahony (University College Cork, Ireland), Tony Heffernan (The Cork Road Clinic, Ireland), David Molony (The Red House Family Practice, Ireland) and Tommy Carroll (The Medical Centre, Ireland)
Copyright: © 2016 |Pages: 9
DOI: 10.4018/978-1-4666-9978-6.ch038
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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).

Key Terms in this Chapter

Computerized Decision Support Systems (Clinical Context): Any electronic system designed to aid directly in clinical decision making, in which characteristics of individual patients are used to generate patient specific assessments or recommendations that are then presented to clinicians for consideration.

Chronic Disease: Long lasting disease that can be managed to some extent, but that cannot be cured.

Electronic Health Record: Digital version of a patient’s paper chart.

Clinical Pathways: Also known as care pathways or care maps, these are used to manage the quality in health care concerning the standardization of care processes. They promote organized and efficient patient health care based on evidence based practice.

General Practitioner: A medical practitioner who treats patients of all ages in the general community, as well as providing preventative and health education to these patients.

Multimorbidity: The coexistence of two or more chronic illnesses in an individual.

Clinical Practice Guidelines: Recommendations that are intended to optimize patient care for a particular disease or illness. These are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.

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