Decentralized care is a revolution in the organization and delivery of
health, bringing services closer to where patients live and working to
maximize the overall fit of medical services to patients’ needs,
circumstances, and lives. Increasingly, we know that to achieve better
health, care must go beyond the hospital to provide quality prevention
services, better manage chronic illnesses, and improve access to and
continuity of care. Many of the most exciting developments in health
innovative thinking have challenged our assumptions and transformed
healthcare practice.
The movement from hospital-centric models to home-based care is part
of a larger de-institutionalization within healthcare. Within our
health system, the hospital has been at the core of ‘patient care’. In
this context, a ‘patient’ needs specialized medical intervention, such
as heart surgery or treating an acute infection. And ‘care’ is
typically provided in hospitals, private clinics, or large, publicly
financed institutions. However, a gradual shift from such
hospital-centric models to an increasing reliance on home-based care
is gaining momentum. As medical technological advances increase and
facilitate more decentralized solutions, this model shows promise in
improving both the efficiency and efficacy of care. A home-based care
model represents a more sustainable solution to the increasing demand
for care.
To facilitate this increasing trend towards home-based care, these
systems feature health software that uses various technologies such as
telemedicine platforms, remote patient monitoring systems, and patient
engagement solutions to help manage care outside of the traditional
inpatient setting. Care can become truly continuous and personalized
because advanced health software helps to connect providers and
patients at a distance and employs data to inform patient-centered
treatment. The growing trend of decentralized care will require health
software solutions that will help providers, patients, and families
become more comfortable monitoring and managing care outside of a
traditional health setting in the home.
Decentralized care is about providing healthcare services outside of
the hospital, in the community, and in the home, largely by supporting
and enabling the patient-centered provision of care and using
technology for seamless data-sharing and continuous monitoring and
management. The basic principles of decentralized care can be boiled
down to patient-centredness, accessibility, and a focus on
technologies that deliver care closer to where patients are (diluting
the one-sided burden of developing new skills and infrastructure to
care for those who need them). This implies that technologies can
support overcoming geographical barriers in care provision, such as
remote consultations and monitoring. In theory, decentralizing care
will provide more flexibility and responsiveness and bring services
closer to patients, reducing the need to travel to a centralized
physical location to receive care.
For patients, the benefits of decentralization include better access
to services, especially in rural or underresourced settings, as well
as comfort and convenience because care can be given at home. It can
also empower patients to manage chronic conditions proactively and
provide better continuity of care, thereby, in turn, leading to
improved health outcomes. For health systems, decentralization can
help ease hospital pressure and costs by reducing hospital admissions,
enabling better allocation of resources, and making financial savings.
Home health care, where trained teams visit patients at home to
provide medical and personal care, is an example of a decentralized
care model. Another is telemedicine platforms offering remote
consultations and follow-up care.
Telemedicine platforms have become essential to decentralized care by facilitating remote interactions between patients and doctors. This includes video consultations, where patients can receive medical advice and treatment without the need to travel to a healthcare outlet. The most significant features of a telemedical platform are video consultations (i.e., face-to-face consultation using the Internet) and remote diagnostics (i.e., symptom-based preliminary diagnoses made by a healthcare professional who observes a patient’s condition by gaining symptomatic information through reported data and digital tools/scanners). Patient access is significantly improved because geographic barriers are eliminated, and telemedicine provides an alternative to a clinic visit for those unable to attend one. Furthermore, telemedicine increases the continuity of healthcare by allowing regular follow-ups and ongoing management of health issues to ensure patients have consistent and timely support for their conditions.
Remote patient monitoring systems allow for tracking and transmitting patient health data in real-time, with such devices often taking the form of a wearable device (such as a smartwatch or fitness tracker) monitoring vital signs (e.g., heart rate, blood sugar measurements, or blood pressure). Features include, for example, the ability to track ‘live metrics’, enabling providers to receive real-time related health data and computational alerts for when a patient’s health data is beyond the normal values. In this way, remote patient monitoring allows for more effective care and management of chronic diseases by intervening in such diseases as soon as health metrics deviate from the normal range. These systems also offer ongoing monitoring and provide necessary insights concerning chronic conditions. For example, a patient with type 2 diabetes may track their diet and physical activity using a smartwatch that connects to remote monitoring software. This allows the nephrologist who treats the patient to track the data in real-time and recommend behavior modifications as needed. This convenient and cost-effective tool reduces in-person patient visits, with insurance payers also benefiting from decreased healthcare costs.
Effective and standardized patient portals and mobile health apps can help patients take more responsibility for their care and make decentralized care work. Patient portals allow patients to access their clinical data, such as their past medical records and test results, check appointment times and dates, ask questions regarding health and medication, and communicate with their care teams. Mobile health apps have additional features in which patients can choose different types of monitoring and self-tracking data to be recorded at home, such as blood glucose, physical activity, weight, daily steps, and training activity. Health apps can also enable patients to request appointments, take medication reminders, and use direct messages. The use of these apps allows home-based care, making decentralized care work. Patient engagement is fostered through the availability of patient portals and mobile health apps in decentralized care models, as they provide easy access to essential health information and tools and features that improve self-care management, caregiver functioning, and program adherence.
Healthcare software plays a big role in increasing access to care because it closes the gap between available care and where patients can receive it. For example, telemedicine offerings and remote patient monitoring can allow patients to receive care without leaving their homes, facilitating care access in underserved or remote geographic areas. This gap closes even further for patients who struggle with mobility, who can now receive much of their care at home. The software helps reduce barriers to care, increases reach, and allows health services to be more inclusive, which can help make the healthcare system more equitable. The software can make care accessible to individuals who might otherwise face significant barriers to in-person services at traditional medical facilities.
Patient engagement and self-management are facilitated when patients use schedules and reminders from these healthcare software tools to track basic metrics during treatments, such as blood glucose levels, heart rate, blood pressure, and medication adherence. For example, mobile health apps can guide patients to continue following a medication regimen and enable them to track and maintain medication adherence by facilitating reminders, developing monitoring abilities, and encouraging self-care. Such direct engagement in healthcare allows patients to be informed participants in their interventions, leading to improved understanding and uptake of the treatment plan. With the help of these tools, patients feel more empowered, become more active, and experience better outcomes. Further, considering the reaction to COVID-19 lockdowns, which challenged the notion that patients must be treated in person, this strategy could make decentralized care more feasible by empowering patients to manage their health.
Healthcare software plays a role in spurring decentralized care models by making them more cost-effective and resource-efficient. For instance, the capability of healthcare software to enable remote monitoring allows clinicians to catch potential issues or flare-ups before they escalate to the point where a hospital admission or emergency visit is needed. People who use remote monitoring to track their blood pressure from a distance can also reduce the use of expensive emergency interventions. Far from inflating costs, healthcare software improves care coordination. By providing ways to integrate the various tasks in a patient’s care, software reduces administrative overhead and contributes to reducing operational costs. This functionality in healthcare software optimizes the use of resources and enhances the efficiency of how healthcare is provided, ultimately contributing to the sustainability of the healthcare system.
Securing patient data while allowing decentralized care is a high priority and must be implemented. Due to the distributed nature of such systems, how they handle and deal with sensitive information is critical, and advanced security measures are needed to prevent data breaches and unauthorized access. Because such systems handle highly sensitive fodder, the security control must be at its peak to adhere to the HIPAA (Health Insurance Portability and Accountability Act) in the US and the similar GDPR (General Data Protection Regulation) in the EU based standards for patient privacy, and laws mandating strict guidelines for the storing, handling, and transmissions of data. This calls for health software providers to implement sophisticated encryption, impenetrable multi-factor authentication processes, and frequent security audits in their applications.
A key barrier to successfully implementing software for DCS is technology adoption related to patients and providers. There are several ways in which technological literacy could be a barrier. First of all, there is a clear generational divide. Using a DCS could be particularly daunting for older patients with less technical understanding of navigating new technologies. Similarly, some providers accustomed to ‘pen and paper’ systems might prefer to continue working in their current format. For these individuals, creative measures to ensure the software has an intuitive user interface and ready access to training and educational material would be constructive.
Integrating new software with existing and system infrastructures is another critical challenge, especially when legacy systems are still in use, for example, in our NHS. New software must integrate, which means finding ways to share data, communicate with existing systems, and address issues with the systems and data consumed in different parts of the healthcare sector. This is critical because any interoperability issues will result in disruptions in care. This will require implementing technical solutions, such as standardizing data formats, using common interoperable platforms, and being adept at using middleware that bridges the gap between systems. Solutions exist that can help healthcare organizations create a unified technology environment. This helps to ensure that new software complements rather than interferes with the existing landscape, enabling a more joined-up approach to decentralized healthcare.
The future of decentralized care will likely be shaped by technologies that transform remote monitoring and diagnoses. The rising capabilities of artificial intelligence (AI) and machine learning will likely find applications in the healthcare sector. In particular, AI tools that can sift through large amounts of data are already being used to detect patterns and predict health risks. At the same time, decision-support tools also feed patients into clinical trials. In addition, augmented reality (AR) and virtual reality (VR) could transform remote consultations through immersive and interactive experiences for patients and carers alike, enhancing the accuracy of remote consultations and restoring some of the interactions of in-person contact.
Looking forward, the trend of home-based care will likely continue to grow, bolstered by technological advances and a greater insistence on patient-centered care. For example, home care in the future is likely to be more integrated, involving not only nursing carers but also encompassing virtual consultations, remote diagnostics, and real-time health monitoring. This form of healthcare is likely to relieve the pressure facing traditional health facilities, decongest the number of hospital beds available, and improve the efficiency of the healthcare system. Given the future sophistication that home-based care is likely to adopt, this form of healthcare will also make it easier to manage various health conditions in a personalized and proactive manner. The results will be better patient outcomes and a more sustainable healthcare system overall.
Decentralized care will continue to rely on the growing healthcare software ecosystem that promotes these changes by facilitating integration and communication between patients and providers. The next generation of healthcare software will probably focus on interoperability – the best sharing and lifting of data between different platforms without piecemeal use and value limitation – as technology evolves to better and more accurately track membership and outcomes in decentralized ways. Healthcare software will also increasingly focus on personalized care and customization strategies to support individualized and more targeted care plans. The software will enable more granular health-management decision-making, from what prescription works best for one person to tailoring multimorbid condition care plans through apps and devices that connect all concerned stakeholders. As decentralized care evolves, the software will underpin the shift while enhancing tools that promote patient activation, integration, and empowerment. New software strategies will continue to drive the future of decentralized care, rendering it more accessible, efficient, and effective for patients and providers.
Changes such as the expansion of home-based care versus hospital-based care, provoked by the availability of technologies based on software, reflect a significant evolution in healthcare. This is because such technologies enable greater use of remote consultations, real-time monitoring, and patient engagement. All these translate into more decentralized and patient-centric care models. Telemedicine platforms, remote monitoring systems, and many mobile health apps are used to improve accessibility and convenience, relieve some burdens on chronic patients, and reduce program and treatment costs. As a result of these initiatives, healthcare is becoming increasingly decentralized, and, therefore, the role of software will be even more important as the sector continues to evolve. In this way, developing and implementing such technologies help ensure that care is maintained as accessible, tailored, and efficient as possible.
Web Sun