Lamine Traore

Background: There is an increasing need to organize the care around the patient and not the disease, while considering the complex realities of multiple physical and psychosocial conditions, and polypharmacy. Integrated patient-centered care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced information and communication technology solutions for semiautomated clinical decision support. Objective: The Collaborative Care and Cure Cloud project (C3-Cloud) has developed 2 collaborative computer platforms for patients and members of the multidisciplinary team (MDT) and deployed these in 3 different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients with 2 or more chronic conditions (diabetes mellitus type 2, heart failure, kidney failure, depression), their informal caregivers, health care professionals, and, to some extent, health care systems. Methods: This paper describes the protocol for conducting an evaluation of user experience, acceptability, and usefulness of the platforms. For this, 2 “testing and evaluation” phases have been defined, involving multiple qualitative methods (focus groups and surveys) and advanced impact modeling (predictive modeling and cost-benefit analysis). Patients and health care professionals were identified and recruited from 3 partnering regions in Spain, Sweden, and the United Kingdom via electronic health record screening. Results: The technology trial in this 4-year funded project (2016-2020) concluded in April 2020. The pilot technology trial for evaluation phases 3 and 4 was launched in November 2019 and carried out until April 2020. Data collection for these phases is completed with promising results on platform acceptance and socioeconomic impact. We believe that the phased, iterative approach taken is useful as it involves relevant stakeholders at crucial stages in the platform development and allows for a sound user acceptance assessment of the final product. Conclusions: Patients with multiple chronic conditions often experience shortcomings in the care they receive. It is hoped that personalized care plan platforms for patients and collaboration platforms for members of MDTs can help tackle the specific challenges of clinical guideline reconciliation for patients with multimorbidity and improve the management of polypharmacy. The initial evaluative phases have indicated promising results of platform usability. Results of phases 3 and 4 were methodologically useful, yet limited due to the COVID-19 pandemic. Trial Registration: ClinicalTrials.gov NCT03834207; https://clinicaltrials.gov/ct2/show/NCT03834207 International Registered Report Identifier (IRRID): RR1-10.2196/21994

Background: Uncorrected refractive errors (URE) are a serious public health problem by their magnitude, the multiple consequences they result in, but also by the inability of the countries of French-speaking Sub-Saharan Africa (FSSA) to meet the needs of the population. Governance problems, associated with human resources problems, financing problems for care, infrastructure and consumables, led us to initiate this study, the objective of which is to analyze the situation of UREs in FSSA with the stakeholders involved in the eye health system. Materials and Methods: We carried out a cross-sectional survey of eye health actors and stakeholders in all of the French-speaking Sub-Saharan Africa countries from March 1st to August 31st, 2020. An online questionnaire was developed and translated into French, and then sent to the targeted eye health stakeholders involved in eye health. The survey and data collection were carried out in two phases: first by collecting information from the eye health officials of the countries which then enabled us to reach all the other actors in the country. Data were entered directly into SPSS 20 software followed by cleaning prior to analysis and presented as percent, mean or median, and standard deviation. Result: A total of 500 questionnaires were sent to the various actors involved in eye health in the 21 countries of French-speaking Sub-Saharan Africa. The number of people who opened the questionnaire is 215, of which 151 have completed at least one question. Eye health policy documents existed in countries according to 95% of respondents. In the words of 76.6%, 54.6% and 85.2% of the participants respectively, the mechanisms for describing the tasks of the agents, for reporting to the actors and for collecting data existed. Also, according to respectively 61.5%, 58.8 % and 61.3% of respondents, the following are not effective: existence of documents of standards and procedures, specific allocation of eye health in the budget of the Ministry of Health and the obligation of continuous training. Conclusion: Although policy documents that comply with standards do exist in the French-speaking region of sub-Saharan Africa, several challenges remain to be taken up; in particular, the involvement of all stakeholders of the health system, and the strengthening in the areas of governance, financial and human resources, as well as the information and supply system for materials and consumables, hence the need to initiate more targeted research activities.

BACKGROUND There is an increasing need to organize the care around the patient and not the disease, while considering the complex realities of multiple physical and psychosocial conditions, and polypharmacy. Integrated patient-centered care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced information and communication technology solutions for semiautomated clinical decision support. OBJECTIVE The Collaborative Care and Cure Cloud project (C3-Cloud) has developed 2 collaborative computer platforms for patients and members of the multidisciplinary team (MDT) and deployed these in 3 different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients with 2 or more chronic conditions (diabetes mellitus type 2, heart failure, kidney failure, depression), their informal caregivers, health care professionals, and, to some extent, health care systems. METHODS This paper describes the protocol for conducting an evaluation of user experience, acceptability, and usefulness of the platforms. For this, 2 “testing and evaluation” phases have been defined, involving multiple qualitative methods (focus groups and surveys) and advanced impact modeling (predictive modeling and cost-benefit analysis). Patients and health care professionals were identified and recruited from 3 partnering regions in Spain, Sweden, and the United Kingdom via electronic health record screening. RESULTS The technology trial in this 4-year funded project (2016-2020) concluded in April 2020. The pilot technology trial for evaluation phases 3 and 4 was launched in November 2019 and carried out until April 2020. Data collection for these phases is completed with promising results on platform acceptance and socioeconomic impact. We believe that the phased, iterative approach taken is useful as it involves relevant stakeholders at crucial stages in the platform development and allows for a sound user acceptance assessment of the final product. CONCLUSIONS Patients with multiple chronic conditions often experience shortcomings in the care they receive. It is hoped that personalized care plan platforms for patients and collaboration platforms for members of MDTs can help tackle the specific challenges of clinical guideline reconciliation for patients with multimorbidity and improve the management of polypharmacy. The initial evaluative phases have indicated promising results of platform usability. Results of phases 3 and 4 were methodologically useful, yet limited due to the COVID-19 pandemic. CLINICALTRIAL ClinicalTrials.gov NCT03834207; https://clinicaltrials.gov/ct2/show/NCT03834207 INTERNATIONAL REGISTERED REPORT RR1-10.2196/21994