Integrated care for optimizing the management of stroke and associated heart disease: a position paper of the European Society of Cardiology Council on Stroke.

The management of patients with stroke is often multidisciplinary, involving various specialties and healthcare professionals. Given the common shared risk factors for stroke and cardiovascular disease, input may also be required from the cardiovascular teams, as well as patient caregivers and next-of-kin. Ultimately, the patient is central to all this, requiring a coordinated and uniform approach to the priorities of post-stroke management, which can be consistently implemented by different multidisciplinary healthcare professionals, as part of the patient 'journey' or 'patient pathway,' supported by appropriate education and tele-medicine approaches. All these aspects would ultimately aid delivery of care and improve patient (and caregiver) engagement and empowerment. Given the need to address the multidisciplinary approach to holistic or integrated care of patients with heart disease and stroke, the European Society of Cardiology Council on Stroke convened a Task Force, with the remit to propose a consensus on Integrated care management for optimizing the management of stroke and associated heart disease. The present position paper summarizes the available evidence and proposes consensus statements that may help to define evidence gaps and simple practical approaches to assist in everyday clinical practice. A post-stroke ABC pathway is proposed, as a more holistic approach to integrated stroke care, would include three pillars of management: A: Appropriate Antithrombotic therapy.B: Better functional and psychological status.C: Cardiovascular risk factors and Comorbidity optimization (including lifestyle changes).

The digital transformation of healthcare - An interview with Werner Dorfmeister.

In this interview, Werner Dorfmeister, a Vice President at DasLab and a former Global Sales Director at Karl Storz, reports on the current developments of digital technologies in the field of medical instruments and services. It is a sector where digitalization affects all processes within hospitals as well as pre- and post-surgical activities. Due to the many actors involved, who use different information systems, and the strong regulation of the entire healthcare sector, crafting digital solutions is complex, but nevertheless promising and necessary. Among the key areas mentioned in the interview are telemedicine, hospital and patient management and a sector-wide digital infrastructure. Digital platforms are described as important enablers to address current inefficiencies and to leverage future potentials towards patient-orientation, such as digital patient pathways.

Werner Dorfmeister was Global Sales Director at Karl Storz SE & Co. KG, a global producer of medical devices headquartered in Tuttlingen, Germany. The company was founded in 1945 and employs about 6'000 people today with annual revenues of approximately two billion Euros. Starting with the invention of the endoscope, Karl Storz has a long tradition in pioneering innovations in the fields of classical, heart and neuro surgery as well as gynecology and otolaryngology. The company is one of the largest producers of surgery instruments and has constantly enhanced its product portfolio with electronic devices and conceptualizing entirely integrated operating rooms. In March 2021, Werner joined DasLab GmbH, a German start-up company that focuses on the digitalization in the field of laboratory medicine. As Vice President Business and Partnerships, he is not only involved in the diagnostics of the Corona pandemic, but also investigates perspectives related to the "digital path" among laboratories, patients and healthcare organizations such as hospitals, physicians and insurance companies. Before joining Karl Storz, he was responsible for global solutions and commercial functions at the B2B services firm DXC.technology, which is a spin-off from Hewlett Packard Enterprises where Werner has worked in various positions since 2008. Prior to this position, he was sales manager at VMware and Microsoft. Werner has a degree in management with an emphasis in business informatics from the Donau University Krems and an MBA in media management from St. Pölten University of Applied Sciences in Austria. Since 1998, he is also a visiting professor at Donau University Krems and since 2014 he is a member of Electronic Markets' advisory board. The pictures show him on the left followed by the interviewers Rainer Alt and Hans-Dieter Zimmermann.

Automated conflict resolution for patients with multiple morbidity being treated using more than one set of single condition clinical guidance: A case study.

BACKGROUND: The number of people in the UK with two or more conditions continues to grow and their clinical management is complicated by the reliance on guidance focused on a single condition. This leaves individual clinicians responsible for collating disparate information from patient management systems and care recommendations to manually manage the contradictions that exist in the simultaneous treatment of various conditions. METHODS/DESIGN: We have devised a modelling language based on BPMN that allows us to create computer interpretable representations of single condition guidance and incorporate patient data to detect the points of conflict between multiple conditions based on their transformation to logical constraints. This has been used to develop a prototype clinical decision support tool that we can use to highlight the causes of conflict between them in three main areas: medication, lifestyle and well-being, and appointment bookings. RESULTS: The prototype tool was used to discern contradictions in the care recommendations of chronic obstructive pulmonary disease and osteoarthritis. These were presented to a panel of clinicians who confirmed that the tool produced clinically relevant alerts that can advise clinicians of the presence of conflicts between guidelines relating to both clashes in medication or lifestyle advice. CONCLUSIONS: The need for supporting general practitioners in their treatment of patients remains and this proof of concept has demonstrated that by converting this guidance into computer-interpretable pathways we can use constraint solvers to readily identify clinically relevant points of conflict between critical elements of the pathway.

User-Centred Design of a Digital Care Plan for Patients and Professionals in Cross-Organisational Teams.

Care for patients with multimorbidity and long-term complex needs is costly and with demographic changes this group is growing. The research project Dignity Care addresses how to improve the care for this patient group by studying how a conceptual shared digital care plan for complex clinical pathways can guide and support cross-organisational care teams. This paper presents the user-centred design process for the digital care plan development. Panels of patients and health care professionals will participate in co-creation user workshops and simulation of complex patients' pathways. The main contribution from this work is recommendations for how to actively involve user groups in digital health development, applying a partly remote approach of user-centred design methodology during the Covid-19 pandemic.