The principles of
- Care is person-centered
- Education is a part of care
- Know the health agenda
- Use the social determinants of health
- Keep accountability
- Communication is open
The care recipient is a full partner in their own care and its leader to the best of their wishes and ability. Care planning leads with person-centered participation followed by provider-centered education.
Care recipients must understand and accept the reasoning and rationale for medical treatment to the best of their wishes and abilities, increasing motivation and responsibility for their own health.
Care planning by members of one’s care team begins with an assessment of health concerns, goals, values, preferences, and capacity.
Care planning merges management of environmental concerns (environmental, behavioral, social, biological, medical) with the management of medical problems (treatments and therapeutics) leading to identification of goals and action planning.
Important steps in the person-centered care plan include who’s accountable, when goals and actions will be completed, and where to go as questions arise.
Streams of communication should be open and accessible to all care team members as their roles and permissions allow.
- The intervention engine drives care
- Provide the right data at the right time
- Population data drives precision medicine
- Health data is continuous
The care planning service should provide actionable steps at the right time, based on new health information that is continuously being collected.
Health is complex. Prevent information overload by analyzing, interpreting and providing the right health information at the right time for the right person.
Care planning feeds the discovery of what works for individuals and populations. Population level data specific to the care recipients demographic and health situation can be used to drive health recommendations.
The care plan should be fluid in its understanding of the care recipient. It should continuously learn more about the care recipients values, preferences, and contraindications based on new information.
- Data must be owned
- Data should be shared
- Data must be responsibly used
- Health data is a public resource
- Data usage must be transparent
Access to your health data is a human right. The patient co-owns or fully owns every personal health data point about themselves.
Clinicians will collaborate with patients to responsibly use health data for betterment of public and patient health.
Criminalize the pejorative use of personal health care data.
Provide access to scientific research, develop tools and materials to engage the imagination of the public and accelerate scientific discovery.
Visibility into who, what, when, how people and services use your health data.