MicroCare

Telehealth portals ...

closer to patients everywhere.

Telehealth portals to implement personalized primary care

Personalized care is a global strategy to future proof healthcare(1) and make health systems sustainable. However, a practical framework for problem solving and stakeholder management is missing.

This research project is about developing a web-based platform that will offer decision-makers the guidance and support needed to develop personalized primary care portals.

Our mission is to accelerate the implementation of personalized care with neighborhood-level portals integrating digital health solutions with green building designs. 

Why telehealth portals?

Patients in urban isolated situations or remote areas need safe and convenient access to medical services.

Larger and smarter service footprints, allow hospital networks to (i) detect and locally isolate infectious patients; (ii) safely transfer high-risk patients and; (iii) cut costs by outsourcing low-acuity cases to smaller care settings.

Primary care ususally works isolated from hospital care forcing patients to receive care through a patchwork of providers at various sites.

Coordinated care in one place offers patients a continuum of care and to practitioners, opportunities to expand their medical services with points of care for imaging, laboratory, endoscopy, and a digital health platform.

Policy makers recognize inefficiencies in healthcare delivery, the shortage of health professionals, and the growing health inequalities and inequity in access to healthcare.

Population health management at the neighborhood level can help plan targeted health services and improve resource allocation. 

70% to 80% of all healthcare costs in the EU – Ca. €700 billion – are currently spent on chronic diseases. A large sum is attributable to avoidable hospital costs.

Effective prevention and efficient disease management of age-related and lifestyle related diseases is also healthy for health insurance companies.

MicroCare, the kickstarting concept

In-person and Digital Care managed in one place!

MicroCare employs a focus where patients are empowered to actively participate in their care. Where health managers have a central role in welcoming the patient and coordinating a team of in-house specialists around the patient’s needs(2). It integrates care following the hub-and spoke model, an adaptive system that arranges care for different levels of acuity(3). For example, when intensive medical services are required, the manager at the spoke can arrange the care needed with the hub, a large, specialized hospital. Our concept, mimicking this model, is increasingly adopting Healthcare 4.0 technologies which effectively improve every stage of the patient care pathway(4).

MicroCare is a robust curated template that will kickstart transdisciplinary research with a hospital operator and a recipient community. Participants will customize and further develop the concept aiming to give practical recommendations to project developers at other sites. The feedback will be an invaluable contribution to continue refining the platform and its APPs.

• Multidisciplinary outpatient care customized to local demands
• Emergency situations 24 hours, 7 days a week
• Tele-imaging with specialists in allied centers
• General surgery, catheterization, and endoscopy
• Monitored transfers towards and from more complex hospitals
• Optional low-acuity inpatient stays with an 8 to 12 bed capacity

The portal is two stories high within a 4,500 m² plot.
The ground floor has 1,500 m² for emergency, diagnostics, and non-invasive surgery. As well, a wing for external consultation and a 1,750 m² park for the positive dis­traction of all users and visitors
In 1,200 m² the upper floor accommodates minimally invasive surgery workplaces, the patient ward, laboratory, and other ancillary services.  

Patients in urban isolated situations or remote areas need safe and convenient access to medical services.

Larger and smarter service footprints, allow hospital networks to (i) detect and locally isolate infectious patients; (ii) safely transfer high-risk patients and; (iii) cut costs by outsourcing low-acuity cases to smaller care settings.

Digital care applies digital health capabilities and technologies to:  (i) improve patient experiences and outcomes, (ii) streamline operational processes, and (iii) reduce costs.

It integrates telemedicine for long-distance patient care with a variety of digital healthcare services for self-care. 

MicroCare research, 1 Platform with 3 APPs

The transdisciplinary research counts with a stakeholder management platform with 3 APPs. The platform will allow participants to co-develop a MicroCare portal with fluent communication tools and intuitive data processing interfaces. The APPs target groups potentially involved in the three most important development phases of the project. 

APP 1, HEALTH SERVICE PLANNER offers interactive guidance on how to develop digital health and in-person care services;

APP 2, ENVIRONMENT DESIGNER is instrumental in gathering and producing evidence to create MicroCare’s digital and built environments; 

APP 3, OPEN BUILDER streamlines efforts to deploy and build MicroCare. 

Service Planning APP

Step-by-step guidance for health officials, and hospital promoters, operators, and managers to develop health services fitting the demands and potentials of the local population. 

Requirements: a problem case must be defined and stakeholders committed to participate. 

Outputs: a health demand model is obtained to help customize the MicroCare digital health platform and building.

Digital care

TELEMEDICINE
TELECARE

Walk-in care

Requirements: a problem case must be defined and stakeholders committed to participate. 

Outputs: a health demand model useful to customize the MicroCare digital health platform and building.

Environment Design APP

This APP is instrumental in gathering and producing evidence useful for digital health developers, building designers, and end users to create MicroCare’s environments at a specific site.

Requirements: a health demand model is central to design MicroCare’s digital health and in-person services. Equally important is to involve staff, patients, and relatives in a user-centric design approach to discuss and customize the project through the APP.

Outputs: (i) the digital health platform and (ii) the building design. These two outputs are possible by gathering information from participant interactions and tracking the designers’ desicion-making processes.

Open Building APP

Tools will streamline the modular building manufacturing and apply an open building approach that involves local builders and the community.

Evidence is gathered applying a user-centric design approach. Staff, patients, and relatives are invited to participate in discussions and customize the project through the APP.

Evidence to drastically lower the significant ecological footprint .

 

to drastically lower the significant ecological footprint
by reducing waste in the entire building execution process

lower CO2-emissions by extending the lifespan of buildings and engaging in circular economies.

OPEN BUILDING
+ 60% traditional construction
OPEN BUILDING
+ 60% traditional construction
MODULAR BUILDING
Core health services manufactured off-site
MODULAR BUILDING
Off-site manufacturing steps

Requirements: a health demand model is central to design MicroCare’s digital health and in-person services. Equally important is to involve staff, patients, and relatives in a user-centric design approach to discuss and customize the project through the APP.

Outputs: evidence is digitally gathered from participant interactions and the designers’ desicion-making processes.

• patient-centred care  • user-centric design  • eco-friendly building

Credits

MicroCare, telehealth portals to implement personalized primary care © 2021 by Alvaro Valera Sosa is licensed under CC BY-NC-ND 4.0 

Project development

Alvaro Valera Sosa: MicroCare conceptualization, investigation, methodology (E-bD planning framework), and concept design of the unit.
Wolfgang Sunder: technical-medical design of MicroCare’s core health services requiring modular construction.
Prof. Jacob van Rijs: building design and implementation procedures applying an open building approach.

Webpage development

BHL Building Health Lab
Alvaro Valera Sosa: Original draft, Writing-reviewing, Editing, Design, Administration.
Netra Naik: Software, Data curation.
Julia Reißinger: Software, Data curation.

Links and sources

1.  https://www.futuremedicine.com/doi/10.2217/pme-2020-0115
2. https://www.pcpcc.org/resource/patient-centered-medical-home-what-patient-centered-medical-home-pcmh
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751794/pdf/12913_2017_Article_2755.pdf
4. https://www.sciencedirect.com/science/article/abs/pii/S0169409X21003513
5. https://www.arup.com/covid-19/carebox
6. https://www.openbuilding.co/