eHealth Advances in Support of People with Complex Care Needs: Case Examples from Canada, Scotland and the US

Abstract

Information technology (IT) in healthcare, also referred to as eHealth technologies, may offer a promising solution to the provision of better care and support for people who have multiple conditions and complex care needs, and their caregivers. eHealth technologies can include electronic medical records, telemonitoring systems and web-based portals, and mobile health (mHealth) technologies that enable information sharing between providers, patients, clients and their families. IT often acts as an enabler of improved care delivery, rather than being an intervention per se. But how are different countries seeking to leverage adoption of these technologies to support people who have chronic conditions and complex care needs? This article presents three case examples from Ontario (Canada), Scotland and Kaiser Permanente Colorado (United States) to identify how these jurisdictions are currently using technology to address multimorbidity. A SWOT (strengths, weaknesses, opportunities, threats) analysis is presented for each case and a final discussion addresses the future of eHealth for complex care needs. The case reports presented in this manuscript mark the foundational work of the Multi-National eHealth Research Partnership Supporting Complex Chronic Disease and Disability (the eCCDD Network); a CIHR-funded project intended to support the international development and uptake of eHealth tools for people with complex care needs.

Multimorbidity patterns in adult day health center clients with dementia: a latent class analysis

“…In the absence of unlimited funding, information and communication technology represents a scalable and economical approach to integrating ADCs into the care continuum that supports comprehensive coordination of health and social support for PLWD with multimorbidity [ 44 , 45 ]. Members of the care team (eg, patients, informal caregivers, pharmacists, nurses, social workers) can communicate more seamlessly across settings with the help of shared information systems that leverage technology [ 46 ].…”

Exploring the perspectives of primary care providers on use of the electronic Patient Reported Outcomes tool to support goal-oriented care: a qualitative study

“…As previously described by Steele Gray & colleagues [ 18 , 23 , 24 ], the ePRO tool was designed to support self-management and shared decision making through collaborative use by a patient, caregiver(s) and health care provider(s). To improve adoption, it was co-designed with end-users, including health care providers, content experts, patients with complex care needs and their caregivers [ 10 , 18 , 24 ]. Interviews with six primary care providers during a six-week pilot usability evaluation of an earlier version of the ePRO tool revealed implementation barriers that prevented the adoption of the tool in clinical practice.…”

“…Digital health solutions may help primary care better address the needs of patients with chronic conditions through improved access to communication tools, symptom monitoring and self-management support [ 9 , 10 ]. For instance, mobile health (mHealth) can allow providers to monitor patients’ symptoms, medication adherence and activity patterns outside of a primary care clinic [ 9 ].…”

Aligning Virtual Care in Canada with the Needs of Older Adults

“…Some older adults may have trouble pinching and swiping or have difficulty reaching with the thumb across an interface while holding the device in one hand. Many digital health tools focus on single-disease populations, but most older adults have multiple interacting causes of chronic disease and disability (Becker et al, 2014; Steele Gray, Mercer, Palen, McKinstry, & Hendry, 2016). Virtual care for older Canadians represents an (as yet unfilled) opportunity to integrate oft-siloed health services.…”