Digital Health Transformation of Integrated Care in Europe: Overarching Analysis of 17 Integrated Care Programs

Baltaxe, Erik; Czypionka, Thomas; Kraus, Markus; Reiss, Miriam; Askildsen, Jan Erik; Grenković, Renata; Lindén, Tord Skogedal; Pitter, J; Mölken, Maureen P. M. H. Rutten-van; Solans, Óscar; Stokes, Jonathan; Struckmann, Verena; Roca, Josep; Cano, Isaac

doi:10.2196/14956

Cited by 60 publications

(51 citation statements)

References 53 publications

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“…Our findings show the heterogeneity of (catching-up) activities related to data integration, so that the basis for comprehensive approaches has not yet been created throughout Europe. This is also in line with a recent study about integrated care programs in Europe [94] and with the Annual European eHealth Survey 2018 [95] that identifies diverse eHealth priorities: e.g., Germany has the highest priority in EMR implementation and UK in improving clinical access to information. The survey states that the top 3 challenges of healthcare providers are funding, standards for interoperability, and IT security.…”

Section: Digitization Of the Healthcare Systemssupporting

confidence: 88%

Implementation of eHealth and AI integrated diagnostics with multidisciplinary digitized data: are we ready from an international perspective?

et al. 2020

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Digitization of medicine requires systematic handling of the increasing amount of health data to improve medical diagnosis. In this context, the integration of the versatile diagnostic information, e.g., from anamnesis, imaging, histopathology, and clinical chemistry, and its comprehensive analysis by artificial intelligence (AI)–based tools is expected to improve diagnostic precision and the therapeutic conduct. However, the complex medical environment poses a major obstacle to the translation of integrated diagnostics into clinical research and routine. There is a high need to address aspects like data privacy, data integration, interoperability standards, appropriate IT infrastructure, and education of staff. Besides this, a plethora of technical, political, and ethical challenges exists. This is complicated by the high diversity of approaches across Europe. Thus, we here provide insights into current international activities on the way to digital comprehensive diagnostics. This includes a technical view on challenges and solutions for comprehensive diagnostics in terms of data integration and analysis. Current data communications standards and common IT solutions that are in place in hospitals are reported. Furthermore, the international hospital digitalization scoring and the European funding situation were analyzed. In addition, the regional activities in radiomics and the related publication trends are discussed. Our findings show that prerequisites for comprehensive diagnostics have not yet been sufficiently established throughout Europe. The manifold activities are characterized by a heterogeneous digitization progress and they are driven by national efforts. This emphasizes the importance of clear governance, concerted investments, and cooperation at various levels in the health systems. Key Points • Europe is characterized by heterogeneity in its digitization progress with predominantly national efforts. Infrastructural prerequisites for comprehensive diagnostics are not given and not sufficiently funded throughout Europe, which is particularly true for data integration. • The clinical establishment of comprehensive diagnostics demands for a clear governance, significant investments, and cooperation at various levels in the healthcare systems. • While comprehensive diagnostics is on its way, concerted efforts should be taken in Europe to get consensus concerning interoperability and standards, security, and privacy as well as ethical and legal concerns.

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Section: Digitization Of the Healthcare Systemssupporting

confidence: 88%

Implementation of eHealth and AI integrated diagnostics with multidisciplinary digitized data: are we ready from an international perspective?

et al. 2020

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“…The research available in this area focuses mainly on specific implementations, such as the psychotherapeutic treatment of mental illnesses or the diagnosis of skin diseases using digital tools, in more traditional telemedicine or in related areas such as online journals [ 10 ]. However, more research is needed on digital health care services, both because many conditions that are currently handled in digital health care services have not yet been investigated and because new digital tools that can change digital and physical health care services and care processes are constantly being developed and need to be evaluated separately [ 11 , 12 ]. In this study, we defined digital health as “the cultural transformation of how disruptive technologies that provide digital and objective data accessible to both caregivers and patients leads to an equal level doctor-patient relationship with shared decision-making and the democratization of care [ 13 ].”…”

Section: Introductionmentioning

confidence: 99%

Patients’ and Health Care Professionals’ Perceptions of the Potential of Using the Digital Diabetes Questionnaire to Prepare for Diabetes Care Meetings: Qualitative Focus Group Interview Study

Eeg‐Olofsson¹,

Johansson²,

Linder³

et al. 2020

J Med Internet Res

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Background In effective diabetes management, it is important that providers and health care systems prioritize the delivery of patient-centered care and that they are respectful of and responsive to individual patient preferences and barriers. Objective The objective of the study was to conduct focus group interviews to capture patients’ and health care professionals’ perceptions and attitudes regarding digital technology and to explore how the digital Diabetes Questionnaire can be used to support patient participation in diabetes care, as a basis for an implementation study. Methods A qualitative study was conducted with six focus group discussions with diabetes specialist nurses and medical doctors (n=29) and four focus group discussions with individuals with diabetes (n=23). A semistructured focus group interview guide was developed, including probing questions. The data were transcribed verbatim, and qualitative content analysis was performed using an inductive approach. Results Two main categories were revealed by the qualitative analysis: perceptions of digital technology and the digital questionnaire in diabetes management and care and perceptions of participation in diabetes care. An overarching theme that emerged from the focus group interviews was patients’ and professionals’ involvement in diabetes care using digital tools. Conclusions The analysis identified important factors to consider when introducing the digital Diabetes Questionnaire in clinical use. Both professionals and patients need support and training in the practical implementation of the digital questionnaire, as well as the opportunity to provide feedback on the questionnaire answers.

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“…Most studies are conducted within one healthcare domain [ 15 , 16 ] or on patient portals for specific conditions [ 17 , 18 ]. Although eHealth tools have been put forward as central for improving integrated care [ 19 , 20 ] few studies have focused on the processes of establishing a patient portal across healthcare domains [ 21 ]. Furthermore, we have not found any studies that investigate experiences of setting up a patient portal for services across healthcare domains.…”

Section: Introductionmentioning

confidence: 99%

Participants’ views and experiences from setting up a shared patient portal for primary and specialist health services- a qualitative study

Nøst

Faxvaag

Steinsbekk

2021

BMC Health Serv Res

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Background Recently, there has been an increasing focus among healthcare organisations on implementing patient portals. Previous studies have mainly focussed on the experiences of patient portal use. Few have investigated the processes of deciding what content and features to make available, in particular for shared portals across healthcare domains. The aim of the study was to investigate views on content and experiences from the configuration process among participants involved in setting up a shared patient portal for primary and specialist health services. Methods A qualitative study including 15 semi-structured interviews with persons participating in patient portal configuration was conducted from October 2019 to June 2020. Results Whether a shared patient portal for all the health services in the region should be established was not questioned by any of the informants. It was experienced as a good thing to have numerous participants present in the discussions on configuration, but it also was said to increase the complexity of the work. The informants considered a patient portal to be of great value for patient care, among other things because it would lead to improvements in patient follow-up and increased patient empowerment. Nevertheless, some informants advocated caution as they thought the patient portal possibly could lead to an increase in healthcare providers’ workloads and to anxiety and worries, as well as to inequality in access to health care among patients. The findings were categorized into the themes ‘A tool for increased patient involvement’, ‘Which information should be available for the patient’, ‘Concerns about increased workload’, ‘Too complex to use versus not interesting enough’, ‘Involving all services’ and ‘Patient involvement’. Conclusions Establishing a shared patient portal for primary and specialist health services was considered unproblematic. There was, however, variation in opinions on which content and features to include. This variation was related to concerns about increasing the workload for health care providers, causing anxiety and inequality among patients, and ensuring that the solution would be interesting enough to adopt.

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Digital Health Transformation of Integrated Care in Europe: Overarching Analysis of 17 Integrated Care Programs

Cited by 60 publications

References 53 publications

Implementation of eHealth and AI integrated diagnostics with multidisciplinary digitized data: are we ready from an international perspective?

Implementation of eHealth and AI integrated diagnostics with multidisciplinary digitized data: are we ready from an international perspective?

Patients’ and Health Care Professionals’ Perceptions of the Potential of Using the Digital Diabetes Questionnaire to Prepare for Diabetes Care Meetings: Qualitative Focus Group Interview Study

Participants’ views and experiences from setting up a shared patient portal for primary and specialist health services- a qualitative study

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