Assessing Progress Toward the Vision of a Comprehensive, Shared Electronic Care Plan: Scoping Review

Area of Science:

• Health Informatics
• Chronic Disease Management
• Health Services Research

Background:

• Current care plans are fragmented, hindering effective care delivery for patients with multiple chronic conditions across various settings.
• Electronic care (e-care) plans offer a dynamic solution for improved care coordination and addressing holistic health needs.

Purpose of the Study:

• To review existing e-care plans and related initiatives for developing comprehensive, shared e-care plans.
• To inform a joint initiative by the National Institutes of Health and the Agency for Healthcare Research and Quality on e-care planning tools.

Main Methods:

• A scoping review of literature from 2015 to June 2020 was conducted using Scopus, Clinical Key, and PubMed.
• Expert interviews were used to identify initiatives not found in the literature search.
• Data extraction focused on initiative perspective, scope, network, context, and use of open syntax and semantic standards.

Main Results:

• Seven e-care plan projects and three health care data standards projects were identified.
• Existing projects provide foundational infrastructure for shared e-care plans, with some incorporating social determinants of health.
• Most projects utilized open syntax standards, but only three specified open semantic standards.

Conclusions:

• Comprehensive, shared, interoperable e-care plans can significantly enhance care coordination for individuals with multiple chronic conditions.
• While no current project fully meets optimal criteria, existing infrastructure is valuable for future development.
• Addressing critical gaps in interoperability and semantic standards is essential to realize the vision of optimal e-care plans.