Collaboration

Collaboration, while beginning with a consortium of like minded people and companies who undertook to create a patient-centered health information framework and then design and integrate process to foster better patient outcomes by allowing the patient to a partner in their own care team. The most critical part of the partnership is have access to existing digital health information as the foundation upon which they can contributes their personally derived data and other data derived by allied medical practitioners.

Relationships

“Relationships” exist as part of the normal course of interacting with other individuals or employees of a company. The Relationships are created from the perspective of the Owner. Owner in the Relationship (“Rel”) also the Subject (party) while the Object is other party to the “Rel”. The Owner defines their understanding of the relationships type (care team, medical service provider …) and then each party’s role (Patient and Practitioner). The Object Party to the Rel is informing and invited to participate in the relationship.

Trusted Relationships

A “Trusted” Relationship is the process by which a Patient organizes and secures sensitive or confidential information to be used by the “Trusted” party to fulfill their responsibilities. The Responsibilities are defined by a specific agreement (e.g. Health Representative) or a member of a group (e.g. Emergency Contacts or Care Team) . The secure capsules are created and may contain the Patient’s Emergency Medical Summary or Patient Medical Summary, messages with instructions and there documents to be used in delivering the intended services.

Emergency Medical Summary

Emergency Medical Service providers and Emergency Departments end up receiving and treating patients at their most vulnerable and often in widely varying states of incapacity due to injury or sudden onset of a disease or condition. Emergency Contacts can be critical in getting the right treatments that do not interfere with preexisting conditions, medications, allergies or reactions. The worldwide, universally accessible “eMS” report (emergency Medical Summary) contains a standardized and prioritized list designed to save the patient’s life. Once stabilized, the Patient Medical Summary and Treatments Plans can be used to assist in completing the discharge care summary.

Care Team & Treatment Plans

Care Team is a group of practitioners (medical and allied medical) and service provider (health and others) plus friends or family members acting as caregivers collectively assisting the individual in maintaining health and long life. All parties in the Care Team including the Patient provide service, data and insights contributing to an increasingly valuable and accurate digital personal health record.

A single integrated Treatment Plan that is accessible, integrated across practitioners, monitored and contributed to by all Care Team members is designed to achieve practical patient outcomes through coordinated use of patients time and financial resources. The foundation of the Treatment Plan (not Plans) is a common, validated, patient history integrated into collaborative plan with continuous outcome tracking.

Patient and Allied Medical Practitioner Derived Data

While a substantial part of a personal medical summary is contributed to by the primary care system (insurer and medical service delivery), the patient living with a chronic disease or injury plus their network of Allied Medical Practitioners (“AMP”) contributes services and data as part of maintaining and managing a chronic care plan. The combined Derived Data from the AMP and Patient observations and personal health device device data is a supplement to primary care systems data.

Know Your Own Rights (Freedom of Information trumps Privacy and Protection)

Freedom of Information and the law relating to access to information held by a:

1. Government or Public institution (health insurer or authority, hospital or large clinic) or a,
2. Private company (Private Medical or Health Insurer (hospital or clinic) plus Physician Office or Clinic)
3. Practitioner or Care Provider;

means that all parties (companies and practitioners) are all subject to the same federal, province/state laws providing patients or their representatives access to a “copy” of their health and other personal information maintained by the parties.

1. The holder of the information “must” comply, end of story.
2. The only flexibility is in the time period to comply and even then it should be within 45 days of request but;
3. May request (from the patient) a single extension for valid reasons but;
4. Total term from request date (mailing, fax or email date) may not exceed a total of 9o days.
5. Any charges must be reasonable, but given the existence of physician EMR and facility EHR System these should be no charge.
6. Any obscuring or redacting of information must retain material facts, dates, values or diagnoses and reports. (often called “doctors notes”)
7. Most doctors new or beginning practice in last 20 years are fully digitally literate.

Patients of Canada (from Project to NPO)

Patients of Canada is starting its life as a project sponsored by an existing Rare Disorder Society. Once underway, it intents to become its own Non-Profit Organization (NPO) as the first in a series of Patients of Canada NPOs partners each either regionally or vertically organized to provide its patient and family caregiver members the services of a registrar, localization services, advocacy, integrated health care and navigation services.

Why would a socially responsible for profit company (Collaborative Solutions) recommend formation and sustainable support for a Non-Profit-Organization (Patients of BC)? 

Collaborative Solutions is a technology company with shareholders. Additionally, there companies collaborating with CS4 by providing licensed software to the WhoKnozMe – Multi-Function Platform (MFP) for a future royalty consideration. They, along with other shareholders, invested in the development of the Medical Information Framework (MIF) and LifeLine Patient and Administrators Portals. CS4 seeks a “reasonable” return on investment derived from modest Software as a Service Fees earned over a large population of users.

CS4 will have not direct interest, ownership or governance participation “Patients of Canada.” CS4 but will sign a long term agreement to license technology, provide maintenance updates support and operational services to PoC. It support both innovation and research as a developer and technology integrator.

CS4 intends to grant Investor Two options totally 2.5 common shares at $0.20/share for an 20% Ownership of CS4 to PoC to provide sustainability to it operations. The Options are redeemed through payment of $25 per Member/User and $12.50 per Participant and in return CS4 grants a lifetime One-Time-License for its LifeLine Patient Modules (ePHRecord, Digital Logbook and Treatment Planner and Coaching/Adherence).

The CS4 Articles allow all shareholders to have a first right of refusal to maintain or expand their ownership position in CS4 with each new offering.

Because CS4 is charging a subscription fee we are not a Facebook, Google, LinkedIn, Twitter and others where the user and their data is the product for corporate profit. Collaborative Solutions has gone to great lengths to isolate itself from the patient/user personally-private and private information.

There is value in patient information but any monetary value derived from it use in research or innovation should accrue to the patient or their designated non-profit-organization who are representing their common interest. Collaborative Solutions has a number of strategies to support and provide sustainability for an NPO.

The structure and organization of Patient of Canada is contemplated to start in the jurisdiction the British Columbia as a Medical Service Plan (MSP) insurer Health Insurance BC which is consistent with MSP plans administered provincially and territorially and then other vertically structured MSP plans for federally organized groups i.e. armed forces, veterans, diplomats, indigenous or other citizen population groups with national patient interests.

The Patient of BC/Canada concept was first proposed as a cooperation between Collaborative Solutions, the Canadian Pituitary Patient Network and Vancouver Acromegaly Support Group with an opportunity to engage with at least one national organization starting with Canadian Organization of Rare Disorders (CORD).

Using Government of British Columbia as the example, BC provides oversight on key provincial demographic and marketplace classifications including: Seniors, Children and Youth, Information & Privacy, Patient Safety & Quality Council, Athletics, Innovation …. but currently nothing directly related to Patients. Should there be a “Provincial” Advocate, Commissioner or Council or simply a separate patient funded and managed association.

A similar reference concept for Patient of Canada (BC etc.) followed CS4’s study of professional colleges or associations (Medical, Legal, Engineering and others) who are organized both nationally and provincially.

The Royal College of Physicians and Surgeons is national and in BC is the College of Physician & Surgeons of BC both provide accreditation based services. This is similar for the other twenty-two BC medical colleges providing accreditation for other practitioners and providers. In the case of Doctors of BC (NPO : British Columbia Medical Association), the members are physicians and surgeons. One of the many goals is a voice of BC doctors and includes committee work on patient centered care ideology and health promotion.

Patient of BC, in a similar manner to Doctors of BC, intends to represent both past and present patients or groups of patients (societies or NPOs) in the access to and use of medical and health and wellness information and health system navigation services plus encouraging health innovation and patient led research initiatives.

Where could or should “Patients of BC” fit in relation to BC MoH – Health Services?

The taxonomy for BC patient centered care and engagement is found as follows: Government of BC > Ministry of Health (MoH) > Health Services > Primary & Community Care Policy Division > Patient Care Access > Patients Engagement & Community Programs > both Patients as Partners and Community Health Centers.

Under Patients as Partners funds a collection of patient-centered organizations including: Family Caregivers of BC, PainBC, UBC-iCON, UBC-CCMI, UVic Self-Management Programs, Delaney& Associates and Doctor of BC.

Other services include HealthLink BC (811) provides 7/24 access to navigators, registered nurses, dietitians, exercise professionals, and pharmacists. Imaging how effective this services would be with access to a unified patient managed health record the treatment plans and coaching tools.

The BC Patient Safety and Quality Council and its Patient Voices Network (PVN) is where  one  would could have been a logical place include Patients of BC but the PVN is used primarily to provide patient feedback in context of patient care delivery through Health Authorities and their clinical facilities (hospitals, clinics and newly announced Urgent Care Centres).

The BC Support Unit (advanced patient-oriented research) is another possible partner.