Implementation of Digital Monitoring Services During the COVID-19 Pandemic for Patients With Chronic Diseases: Design Science Approach

Abstract

Background The COVID-19 pandemic is straining health systems and disrupting the delivery of health care services, in particular, for older adults and people with chronic conditions, who are particularly vulnerable to COVID-19 infection. Objective The aim of this project was to support primary health care provision with a digital health platform that will allow primary care physicians and nurses to remotely manage the care of patients with chronic diseases or COVID-19 infections. Methods For the rapid design and implementation of a digital platform to support primary health care services, we followed the Design Science implementation framework: (1) problem identification and motivation, (2) definition of the objectives aligned with goal-oriented care, (3) artefact design and development based on Scrum, (4) solution demonstration, (5) evaluation, and (6) communication. Results The digital platform was developed for the specific objectives of the project and successfully piloted in 3 primary health care centers in the Lisbon Health Region. Health professionals (n=53) were able to remotely manage their first patients safely and thoroughly, with high degrees of satisfaction. Conclusions Although still in the first steps of implementation, its positive uptake, by both health care providers and patients, is a promising result. There were several limitations including the low number of participating health care units. Further research is planned to deploy the platform to many more primary health care centers and evaluate the impact on patient’s health related outcomes.

Digital Health Opportunities to Improve Primary Health Care in the Context of COVID-19: Scoping Review

“…The studies covered 18 countries that used digital strategies in PHC; 18 studies were performed in North America (United States [ 29 - 43 ] and Canada [ 44 - 46 ]), 4 studies were performed in South America (Brazil [ 47 - 50 ]), 14 studies were performed in Europe (England [ 51 - 53 ], United Kingdom [ 54 , 55 ], Spain [ 56 , 57 ], Belgium [ 58 , 59 ], Norway [ 60 ], Portugal [ 61 ], Romania [ 62 ], Germany [ 63 ], and Poland [ 64 ]), four studies were performed in Asia (Israel [ 65 ], Oman [ 66 ], Saudi Arabia [ 67 ], and Iran [ 68 ]), and four studies were performed in Oceania (Australia [ 69 - 71 ] and New Zealand [ 72 ]). The characteristics of studies and distribution of countries that used digital strategies in PHC are described in Table 1 and Figure 2 , respectively.…”

“…Nomenclatures regarding remote care strategies varied considerably among studies, with the terms “telehealth” [ 30 , 33 , 36 , 44 , 45 , 47 , 54 , 55 , 60 , 63 , 64 , 67 - 69 , 72 ] and “telemedicine” [ 29 , 31 , 32 , 38 , 39 , 46 , 47 , 51 , 59 , 61 , 63 , 69 , 71 ] being the most frequent. The following terms were also mentioned: teleconsultation [ 40 , 58 , 71 ], virtual visit [ 41 , 48 , 58 ], virtual health/eHealth [ 35 , 51 ], remote consultation [ 37 , 50 , 56 , 65 ], electronic consultation [ 35 , 62 ], telephone follow-up [ 35 , 66 ], video visit [ 35 , 70 ], video consultation [ 34 , 49 ], online consultation [ 69 ], virtual care [ 53 ], web-based video consultation [ 69 ], digital monitoring [ 72 ], nonpresential consultation [ 52 ], and remote self-monitoring [ 43 ].…”

A Digital Health Service for Elderly People with Balance Disorders and Risk of Falling: A Design Science Approach

“…From August to September 2020, we designed an online service, called "BALANCE", following the otoneurologic clinical approach of patients with balance disorders [24]: clinical data, clinical examination findings, instrumental test findings, treatment and the Dizziness Handicap Inventory (DHI) questionnaire [25], a validated self-reported questionnaire that quantifies the impact of dizziness on daily life, pre and post-rehabilitation program. From October 2020 to April 2021, "BAL-ANCE" digital service was implemented and integrated into the digital platform, METHIS (Multimorbidity Management Health Information System) [26], a web-based platform with three relational databases using PostgreSQ and fully integrated with Zoom (Zoom Inc.). The platform METHIS was recently validated for providing remote monitoring services for chronic patients in primary healthcare [26].…”

“…From October 2020 to April 2021, "BAL-ANCE" digital service was implemented and integrated into the digital platform, METHIS (Multimorbidity Management Health Information System) [26], a web-based platform with three relational databases using PostgreSQ and fully integrated with Zoom (Zoom Inc.). The platform METHIS was recently validated for providing remote monitoring services for chronic patients in primary healthcare [26]. For better patient guidance, eight tutorial videos were recorded by the first author (consultant physician), performing the specific balance exercises.…”

Digital Health Interventions and Quality of Home-based Primary Care for Older Adults: A Scoping Review Protocol

“…HBPC was used to reduce attendance at emergency services and the iatrogenic effects of going to health services, to increase testing, and ensure that chronic medical problems were treated, within the home environment, to prevent their worsening [10,11]. Faced with the challenges in PHC from COVID-19, the use of Information and Communication Technologies (ICT) such as the internet, cell phones, computers, software, social networks and other media applications and services which allow to access, retrieve, store, transmit and manipulate information in digital format, and which were already being implemented, became even more prominent [12,13,14]. The use of ICT configures digital health, a series of services and systems, which include medical and health informatics, telehealth, care monitoring, as well as so-called e-learning and mobile health [15].…”