Abstract
Cultural changes are needed in medicine if the benefits of technological advances are to benefit healthcare users. The Digital Health Manifesto of ‘medical futurist’ doctor Bertalan Meskó and ‘e-patient’ Dave deBronkart, The Patient Will See You Now by Eric Topol and The Patient as CEO by Robin Farmanfarmaian, are among the proliferating warnings of the approaching paradigm shift in medicine, resulting, above all, from technological advances that gives users independent access to exponentially increasing amounts of information about themselves. We question their messages only in suggesting they do not sufficiently shift the focus from ‘patient’ to ‘person’ and consequently fail to recognise the need for the credible, efficient, ethical and independent decision support that can ensure the ‘democratisation of knowledge’ is person empowering, not overpowering. Such decision support can ensure the ‘democratisation of decision,’ leading to higher quality decisions and fully-informed and preference-based consent to health provider actions. The coming paradigm will therefore be characterised by apomediative (‘direct-to-consumer’) decision support tools, engaged with by the person in the community to help them make health production decisions for themselves (including whether to consult a healthcare professional or provider), as well as intermediative (‘direct-from-clinician’) tools, delivered by a health professional in a ‘shared decision making’ or ‘co-creation of health’ process. This vision paper elaborates on the implementation of these preference-sensitive decision support tools through the technique of Multi-Criteria Decision Analysis.
Highlights
The Future and the FuturistsIn this vision paper we take as given that the paradigm change in healthcare envisaged by ‘medical futurists’ such as doctors Eric Topol [1] and Bertalan Meskó [2] and patients Robin Farmanfarmaian [3]and Dave deBronkart [4], will happen
If Apomediative Personalised Decision Support Tools (APO PDSTs) are to meet the twin goals of preference-sensitive decisions and an informed and preference-based consent, we argue that the strongest analytical basis is provided by value-based, compensatory Multi-Criteria Decision Analysis (MCDA). (Other versions of MCDA which are either ranking-based or non-compensatory fail key requirements for preference-sensitive decision support)
PDSTthat in the community request the health professional it in the consultation, in order it can be used may in a request that the health professional opens it in the consultation, in order that it can be used in a modified version of intermediation
Summary
In this vision paper we take as given that the paradigm change in healthcare envisaged by ‘medical futurists’ such as doctors Eric Topol [1] and Bertalan Meskó [2] and patients Robin Farmanfarmaian [3]. Sci. 2018, 6, 66 announced ‘democratisation of knowledge’ to realise its potential in health They fail to consider person-focused, preference-sensitive decision support tools as essential in their digital future. Artificial intelligence, robotics, 3D printing, virtual or augmented reality and health sensors have no effect whatsoever without a change in stakeholders' attitudes and the structure of the system Another dimension arriving but not always welcome, is the reality that patients are gaining increasing data at home, continuing the time-honoured trends of home thermometers, home pregnancy tests, insulin test strips, CGMs and so forth. While we can endorse the views of all these authors on how the arrival of active and passive technologies will transform the person’s life both inside their ‘smart home’ and outside it, they have one major shortcoming
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
