When people live with multiple chronic diseases: a wiki-book review

Guest blog by Martin McShane, Director of strategic planning for NHS Lincolnshire

Martin settled into his train-seat. He checked the itinerary he had downloaded into the calendar on his smart phone and realised he had over an hour to kill. With a slightly heavy heart he booted up his laptop and opened the pdf version of the ‘book’ he had been asked to review.  Within minutes of gently scrolling through the document he was engrossed. He was so absorbed by the content that he almost missed his stop and had to hurriedly bundle everything together and leap off the train without shutting his laptop down. The battery died! Luckily he had remembered to bring a charger and was able to finish his reading later that night in the hotel. The book’s relevance to his work, as a doctor turned manager in the English NHS, made it an invaluable resource and one he was eager to promote and share with colleagues as soon as possible.

Each chapter of When people live with multiple chronic diseases: a collaborative approach to an emerging global challenge begins with a story. Each story has relevance and helps draw the reader in. It appeals to me because, when I was seeing patients daily, that is what I dealt with – individual’s stories.

This fascinating venture is designed to bring together a community of people interested in the management of complex chronic diseases, from anywhere in the world. It is supported by the Andalusian Ministry of Health through an Observatory called OPIMEC (the Spanish acronym for Observatory of Innovative Practices for Complex Chronic Disease Management).  As I began to read and reflect upon the content, which has been put together through the collaboration of 55 experts from 18 countries, I began to marvel at the potential this has to address one of the biggest challenges facing health systems across the world. Clinicians, where I work, have challenged my assumptions about pathways and want support to address ‘frailty’. I believe OPIMEC has set out to do exactly that in a way that can keep pace with the rapidity with which evidence emerges and has the potential to facilitate translational research.

The structure of each chapter is constructed around a vignette, a brief summary, why the topic is important, what we know, what we need to know and what innovative strategies could fill the gap. The topics it covers range from the need to create a new taxonomy to better comprehend and tackle polypathology through to the promise of genomics, robotics and nanotechnologies.

Its target audience is anyone with an interest in polypathology: public, professionals and politicians. I especially recommend the section in Chapter 4 on ‘what innovative strategies could fill the gaps’ for all NHS managers, clinicians and civil servants currently terrified by the scale of change implied in new government policy!

This venture is a living, organic, ‘wiki-book’.   It has its faults but these are excusable. The pdf I read was conceived only 12 months before its completion. It summarises progress so far and is a milestone, not a destination. I will be bookmarking this site, using it as resource, using it to reflect and stimulate my thinking and eventually, I hope, contributing what I have learnt.