eHealth for people with multimorbidity: Results from the ICARE4EU project and insights from the “10 e’s” by Gunther Eysenbach

Abstract

BackgroundPeople with multimorbidity, especially older people, have complex health and social needs, and require an integrated care approach. In this respect, eHealth could be of support. This paper aims to describe the implementation of eHealth technologies in integrated care programs for people with multimorbidity in Europe, and to analyse related benefits and barriers according to outcomes from ICARE4EU study and within the more general conceptual framework of the “10 e's” in eHealth by Gunther Eysenbach.MethodsIn 2014, ICARE4EU project identified 101 integrated care programs in 24 European countries. Expert organizations and managers of the programs completed an on-line questionnaire addressing several aspects including the adoption of eHealth. Findings from this questionnaire were analyzed, by linking in particular benefits and barriers of eHealth with the “10 e's” by Eysenbach (Efficiency, Enhancing, Evidence-based, Empowerment, Encouragement, Education, Enabling, Extending, Ethics, and Equity).ResultsOut of 101 programs, 85 adopted eHealth tools, of which 42 focused explicitly on older people. eHealth could improve care integration/management, quality of care/life and cost-efficiency, whereas inadequate funding represents a major barrier. The “10 e's” by Eysenbach seem to show contact points with ICARE4EU findings, in particular when referring to positive aspects of eHealth such as Efficiency and Enhancing quality of care/life, although Empowerment/Education of patients, care Equity and Ethics issues seem crucial in this respect. Encouragement of a new relationship patient-health professional, and Enabling standardized exchange of electronic information, represent further aspects impacting integration/management of care.ConclusionsAspects of eHealth, which emerged as benefits and barriers impacting integration/management of care, as well as cost-efficiency and quality of care/life, can be identified on the basis of both ICARE4EU findings and the “10 e's” in eHealth by Eysenbach. They could represent objectives of new policies for supporting the deployment of eHealth technologies within integrated care across Europe.

Digital telemedicine interventions for patients with multimorbidity: a systematic review and meta-analysis

“…We identified six RCTs eligible for inclusion in the review, reported in seven publications (Wakefield (2011) 1 and Wakefield (2012) 2 reported different outcomes of the same trial) ( table 1 ). No other eligible study designs were identified (detailed characteristics of included studies in online supplemental appendix C ).…”

“…3 Digital telemedicine interventions have in recent years increasingly been recognised as a useful tool that could help integrate and improve care for the complex health and social needs of multimorbid patients, for example, by 'encouragement of a new relationship between patient and health professional, enabling standardised information exchange between providers, and extending the scope of healthcare in a geographical and conceptual sense'. 2 Most digital health research, however, has focused Strengths and limitations of this study ► Multimorbidity is an increasing global challenge and digital health solutions could contribute to improving care. ► Despite the attention given to digital health, no systematic review of digital health interventions for multimorbidity has been conducted before.…”

“… 3 Digital telemedicine interventions have in recent years increasingly been recognised as a useful tool that could help integrate and improve care for the complex health and social needs of multimorbid patients, for example, by ‘encouragement of a new relationship between patient and health professional, enabling standardised information exchange between providers, and extending the scope of healthcare in a geographical and conceptual sense’. 2 Most digital health research, however, has focused on single chronic diseases, patients with multimorbidity are often excluded from studies and reviews, and to date no, systematic review of the effectiveness of digital health interventions for patients with multimorbidity exists. 4 5 In particular, a systematic review of the effectiveness on clinical and quality of life outcomes and the assessment of impact on use of healthcare systems is lacking.…”

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

“…In particular, the adoption of ICTs in health services and processes can innovate the provision of care at distance [19,20], especially useful for older people living in the community [21,22]. ICT has also been identified as a crucial enabler for supporting information sharing across health professionals [23,24].…”

Why does the NHS struggle to adopt eHealth innovations? A review of macro, meso and micro factors

“…Since earlier definitions [9–12], more recent attempts to scope digital health innovation ecosystems illustrate the growing breadth of eHealth [13–15]. This simple term can encapsulate e-health, m-health (sometimes viewed as a subset of eHealth), medicine 2.0, telemedicine and telecare, public health surveillance, personalized medicine/patient engagement, health and medical platforms, self-tracking (the quantified self), wireless health and sensors, medical imaging, healthcare information systems, mobile connectivity, social networking, sensors and wearables, gamification, electronic health records, big data, health information technology, health analytics, and digitized health systems.…”