James F Fleck, MD, PhD

Collective Intelligence Applied to Medicine

Providing general guidelines for patient-centric care

(breaking a long-lasting paradigm) 3

Let’s quickly return to the landmark research of the Picker Commonwealth Program for Patient-Centered Care, based at Boston’s Beth Israel Deaconess Hospital⁴ and published in 1988. The study conducted a national qualitative research to identify the aspects of care most valued by patients, leading to a definition of patient-centered care: “health care that establishes a partnership between professionals, patients and their families, ensuring that decisions respect patients’ wants, needs and preferences and that patients have the education and support they need to make decisions and participate in their own care.” Despite the right approach and its alignment with patients’ expectations, this is rarely observed in daily clinical practice. The most used argument to prevent its applicability is the time spent on this so-called “old-fashioned” healthcare model. However, a good concept never gets old. Currently, resources that integrate healthcare and information technology can break the paradigm of unfeasibility. They allowed us to propose a patient-centric care model that further empowers the patient. It remains respectful and sensitive to individual values, but is more inclusive, giving the patient a controlling role in clinical data flow and quality of care.

3 For better understanding of proposed patient-centric care model go to www.jamesfleck.com.br

4 Dennis F. Beatrice, Cindy Parks Thomas, and Brian Biles: Grant Making With An Impact: The Picker/Commonwealth Patient-Centered Care Program, Health Affairs 17 (1): 236–244, 1998

Patient-centric care guidelines are a tough nut to crack!

Let’s make it easier by following these three steps:

Click in each step to better understand the proposed intervention

Promote proactive patient behavior
from the first contact

STEP  1

Using DHR-embedded clinical
problem-solving methodology

STEP 2

Creating a patient’s customized care team
working in a customized care program

STEP 3

Health is a state of harmony with the fractal expression of nature

GLOBAL NEEDS IN THE HEALTHCARE SYSTHEM

MEET THE PROFESSIONAL

CONTACT

HOME

James F Fleck, MD, PhD

Copyright 2024 – All rights reserved

STEP 1

• The algorithm will guide the patient to schedule a video conference. When proceeding in this way, the patient actively seeks contact with the attending physician. The virtual meeting facilitates the first contact and offers a preliminary interface to promote empathy and belonging. At the same time, the attending physician begins to develop a care plan, always sharing evidence-based medicine and integrative care with the patient. Little by little, the patient will understand what comprehensive care means, assuming a cooperative attitude, being proactive and participating in the introduction of a patient-centric care model.

STEP 2

• This step will take place in a face-to-face consultation, which is essential in clinical care. The personal approach reinforces doctor-patient relationship and allows the physical examination to be carried out. The doctor will then record patient’s clinical data in their personalized-Digital Health Record (DHR). The algorithm directs the attending physician to approach integrative medical care supported by a digitized clinical problem-solving methodology.

STEP 3

• The attending physician appoints all consulting physicians necessary for patient’s comprehensive care, creating a Customized Care Team / CCT. Each CCT is very specific and should work with collective intelligence. The attending physician becomes the conductor and ensures its fine tuning. Working together, CCT will create and complete a Customized Care Program / CCP. A template can be found in the 4-HSN platform (www.4health.network).