Documenting holistic care in a European perspective: What are the priorities?

Abstract

Holistic and integrated care is seen as the way forward, in Europe and globally, for reasons both of efficiency and of human dignity and respect. The concept of putting human values as the focus of community health records was raised twenty years ago , and in the subsequent decades the importance of Integrated Care has come to the fore, so that now holistic care is seen as the vision to strive for. This should bring together formal care provision by both health and social care agencies, family and other informal carer support, and support from civil society. Most recently this has been endorsed by OECD in their publication highlighting the need for new, smarter, health and wellness services , while the European Science Foundation has highlighted that application of ICTs in this area needs social science rather than IT research However, documenting holistic care raises a whole new range of issues and challenges, all of which have to be addressed. Health records are different in nature from social care records, different terminologies are used, and attitudes to third party information and to sharing records are different . Coordination of services across agencies and sectors raises considerable challenges, such as agreeing a common patient diary or schedule . What is now needed is a fresh approach, putting the citizen at the centre of their holistic care record, building up a profile of their needs, preferences, and care schedule, and enabling them to agree to who can see what core information about their pattern of support and the professionals to be contacted in case of urgent need 1. Specialist records, still important, would have controlled feeds into and out of this holistic documentation. Establishing this will be challenging work, balancing information sharing with confidentiality, but it is an essential to ensuring effective caring support to persons with needs.