An example of a Copernican Attitude towards Co-operability

Most eHealth deployments are centred on technological solutions, and organizational changes of increasing complexity are arranged around them ('Ptolemaic' attitude).
We argue that in parallel a 'Copernican' attitude should gain relevance: the roadmaps towards a 'Connected Health' should be centred on the healthcare action plans, supported by suitable eHealth solutions (as EHR and Telemedicine), structurally embedded in the organisational models of shared care pathways. Our focus moves from the 'inter-operability' among systems to the 'co-operability' (i.e. ability to cooperate) among the actors in the care processes.
We apply the above principles to the management of chronic diseases, through an analysis made out of three steps. In step 1, we stratify the patients with respect to their need for care in different phases of the evolution of most chronic conditions. We obtain three stereotypical 'meta-situations' that show similar organisational models across the diseases and the specialties:

1. healthy people and early phases of a disease, which require just a regular attention by the health system and by the citizens themselves;

2. stable, predictable phases that require the proactive management of a (single) condition by multiple actors, which perform stable care tasks according to an agreed care plan;

3. highly complex situations, with the interaction of multiple chronic conditions that require the continuous adaptation of variable care tasks.

We also consider a fourth meta-situation, on the support for the daily activities of the patient and the assistance to the informal caregivers to alleviate their burden.

In step 2, we characterize all of them in a systematic way, from the point of view related to organization, information and communication, and we depict the typical patterns of care management involved, depicting the formal and informal actors that take part in the care processes, describing their roles, their tasks and their mutual responsibilities. In step 3, we investigate the 'Copernican requirements' about the Management of Information, Communication and Knowledge - MICK (the 'MICK landscape') related to each pattern of care management, which is a prerequisite to figure out any appropriate ICT solution.