The development of Future Health Today: piloting a new platform for identification and management of chronic disease in general practice
Barbara Hunter A * , Karyn Alexander A , Ruby Biezen A , Christine Mary Hallinan
A , Anna Wood A , Craig Nelson B C and Jo-Anne Manski-Nankervis A D
A Department of General Practice, University of Melbourne, Melbourne, Vic. 3000, Australia.
B Western Health Chronic Disease Alliance, Department of Nephrology, Western Health, Footscray, Vic. 3000, Australia.
C Department of Medicine Western Health, University of Melbourne, Melbourne, Vic. 3000, Australia.
D NHMRC Centre for Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, University of Melbourne, Melbourne, Vic. 3000, Australia.
Australian Journal of Primary Health 29(1) 8-15 https://doi.org/10.1071/PY22022
Submitted: 8 February 2022 Accepted: 13 October 2022 Published: 2 November 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Chronic disease identification and management is a significant issue in Australia, with general practice being the primary contact point for those at risk of, or living with, chronic disease. However, there is a well-described gap between guideline recommendations for chronic disease management and translation in the general practice setting. In 2018, a group of researchers, clinicians and software developers collaborated to develop a tool to support the identification and management of chronic disease in general practice, with the aim to create a platform that met the needs of general practice. The co-design process drew together core principles and expectations for the establishment of a technological platform, called Future Health Today (FHT), which would sit alongside the electronic medical record (EMR) management system within general practice. FHT used algorithms applied to EMR data to identify patients with, or at risk of, chronic disease and requiring review. Using chronic kidney disease as a clinical focus, the FHT prototype was piloted in a large, metropolitan general practice, and a large regional general practice. Based on user feedback, the prototype was further developed and improved. This paper provides a report on the key features and functionalities that participants identified and implemented in practice.
Keywords: chronic disease, chronic disease management, chronic kidney disease, co-design, general practice, health informatics, innovation, primary care.
References
AIHW (2020a) Chronic conditions and multimorbidity. Available at https://www.aihw.gov.au/reports/australias-health/chronic-conditions-and-multimorbidity [Accessed 18 January 2022]AIHW (2020b) Chronic kidney disease. Available at https://www.aihw.gov.au/reports/chronic-kidney-disease/chronic-kidney-disease/contents/how-many-australians-have-chronic-kidney-disease [Accessed 18 January 2022]
Alexander K, Hunter B, Biezen R, Boyle D, Gunn J, Haikerwal M, Jones J, Janus E, Lumsden N, Manski-Nankervis J (2019) Co-designing technology to improve chronic kidney disease in general practice (University of Melbourne: Melbourne, Vic., Australia) In ‘Poster presentation at 8th annual NHMRC symposium on research translation’. Available at https://futurehealthtodaycomau.files.wordpress.com/2022/01/karyn-alexander-poster-nov-2019.pdf [Accessed 18 January 2022]
Altman M, Huang TTK, Breland JY (2018) Design thinking in health care: a systematic review. Preventing Chronic Disease 15, 180128
| Design thinking in health care: a systematic review.Crossref | GoogleScholarGoogle Scholar |
Brown B, Gude WT, Blakeman T, van der Veer SN, Ivers N, Francis JJ, Lorencatto F, Presseau J, Peek N, Daker-White G (2019) Clinical Performance Feedback Intervention Theory (CP-FIT): a new theory for designing, implementing, and evaluating feedback in health care based on a systematic review and meta-synthesis of qualitative research. Implementation Science 14, 40
| Clinical Performance Feedback Intervention Theory (CP-FIT): a new theory for designing, implementing, and evaluating feedback in health care based on a systematic review and meta-synthesis of qualitative research.Crossref | GoogleScholarGoogle Scholar |
Coleman K, Austin BT, Brach C, Wagner EH (2009) Evidence on the Chronic Care Model in the new millennium. Health Affairs 28, 75–85.
| Evidence on the Chronic Care Model in the new millennium.Crossref | GoogleScholarGoogle Scholar |
Culler SD, Parchman ML, Lozano-Romero R, Noel PH, Lanham HJ, Leykum LK, Zeber JE (2013) Cost estimates for operating a primary care practice facilitation program. The Annals of Family Medicine 11, 207–211.
| Cost estimates for operating a primary care practice facilitation program.Crossref | GoogleScholarGoogle Scholar |
Dimopoulos-Bick TL, O’Connor C, Montgomery J, Szanto T, Fisher M, Sutherland V, Baines H, Orcher P, Stubbs J, Maher L, Verma R, Palmer VJ (2019) “Anyone can co-design?”: a case study synthesis of six experience-based co-design (EBCD) projects for healthcare systems improvement in New South Wales, Australia. Patient Experience Journal 6, 93–104.
| “Anyone can co-design?”: a case study synthesis of six experience-based co-design (EBCD) projects for healthcare systems improvement in New South Wales, Australia.Crossref | GoogleScholarGoogle Scholar |
Greenhalgh T (2018) How to improve success of technology projects in health and social care. Public Health Research & Practice 28, e2831815
| How to improve success of technology projects in health and social care.Crossref | GoogleScholarGoogle Scholar |
Hager MR, Narla AD, Tannock LR (2017) Dyslipidemia in patients with chronic kidney disease. Reviews in Endocrine and Metabolic Disorders 18, 29–40.
| Dyslipidemia in patients with chronic kidney disease.Crossref | GoogleScholarGoogle Scholar |
Hunter B, Biezen R, Alexander K, Lumsden N, Hallinan C, Wood A, McMorrow R, Jones J, Nelson C, Manski-Nankervis J-A (2020) Future Health Today: codesign of an electronic chronic disease quality improvement tool for use in general practice using a service design approach. BMJ Open 10, e040228
| Future Health Today: codesign of an electronic chronic disease quality improvement tool for use in general practice using a service design approach.Crossref | GoogleScholarGoogle Scholar |
Kidney Health Australia (2020) ‘Chronic Kidney Disease (CKD) management in primary care.’ 4th edn. (Kidney Health Australia: Melbourne, Vic., Australia) Available at https://kidney.org.au/health-professionals/ckd-management-handbook [Accessed 18 January 2022]
Pefanis A, Botlero R, Langham RG, Nelson CL (2018) eMAP:CKD: electronic diagnosis and management assistance to primary care in chronic kidney disease. Nephrology Dialysis Transplantation 33, 121–128.
| eMAP:CKD: electronic diagnosis and management assistance to primary care in chronic kidney disease.Crossref | GoogleScholarGoogle Scholar |
