Abstract
Across the world there is a growing demand for health services driven by an ageing, less healthy population suffering from increasing levels of multi-morbidity. Alongside, patients are now mature and experienced consumers with increasing levels of expectation of service delivery. As a result of all these factors, health systems are having to find ways to serve increasing numbers of "Unhealthy Consumers".
However, the global shortage of healthcare staff means that we need to find other ways to help to satisfy the growing demand.
The concept of remote care to enable people to manage as close to home as possible (“Stay Left, Shift Left”) can: improve the quality of care; improve quality of life; and reduce demand and costs, especially when digital health tools are used to significantly increase the impact and reach.
This paper explores the approaches that are needed to enable Stay Left, Shift Left to succeed with a specific focus on engaging, educating and empowering patients.
In this paper we propose that there are two particular interrelated themes that need pursuing; firstly, changing the role of the patient in the care pathway and secondly, using local health care systems and health care professionals to bring about the required change in patients.
We propose that to achieve and deliver the potential of Stay Left, Shift Left, patients who use digital tools in most other aspects of their daily life, have to be activated to achieve increasing levels of maturity of self-management and independence. We identify a Model of Patient Self Care Capability Maturity Framework that will help patients improve their health and health care professionals and health systems to better understand and bring about increasing maturity in their patients.
Patients will not do this on their own initiative, and they need to be encouraged, enabled and facilitated.
For that to happen, health systems need to set the context and build the necessary capabilities and we propose a Person/Patient Capability Maturity Framework which codifies the evolutionary path and journey of patients moving from early stages of engagement through five levels of maturity including education to ultimately patients excelling.
The paper concludes by showing how this CMF has been used to inform a significant patient enabled living lab at Dublin's Mater hospital.