Information and Communication Technologies to Support Chronic Disease Self-Management: Preconditions for Enhancing the Partnership in Person-Centered Care

Abstract

Objective In order to alleviate the pressure on health care systems exerted by the growing prevalence of chronic diseases, information and communication technologies (ICT) are being introduced to enable self-management of chronic diseases by supporting partnerships between patients and health care professionals. This move towards chronic disease self-management is accompanied by a shift in focus on integrating the patient with his or her perceptions on the chronic disease as a full-fledged partner into the health care system. This new perspective has been described as “person-centered care” (PCC). To date, information and communication technologies only partially build on the principles of PCC. This paper examines the preconditions of ICT to enable a person-centered approach to chronic disease management. Methods Using cancer treatment as a case study for ICT-enabled PCC, we conducted a comparative analysis of thirteen scientific studies on interventions presented as ICT-enabled PCC for cancer treatment, to answer the research question: What are the preconditions of ICT-enabled PCC in chronic disease management? Based on the intended and actual outcomes, we distilled in several analytic steps the preconditions of ICT-enabled PCC for chronic disease self-management. Results We distinguished four user-related preconditions of ICT-enabled PCC: (shared) decision making, personalized ICT, health-related quality of life, and efficiency. Conclusions We argue that these four preconditions together can improve people’s self-management of chronic diseases by strengthening the partnership between the patient and the healthcare professional. Moreover, the study revealed a discrepancy between intended and reported actual outcomes in terms of realizing person-centered care.

The Importance of Information and Communication Technologies (Ict) to Promote Information, Self-Care and Empowerment in Patients With Chronic Diseases

“…We can expect specialized patient-centered websites to arise in response to specific chronic disease information need. So, patients become their own principal caregivers, and health care professional are seen as "consultants" supporting them in this role [6]. It's not always like that, ICT applications do not take into account the partnership between patients and health care professionals and are focused on only one of these parties rather than considering both [25].…”

“…This requires the involvement and active participation of the patient in his own health process like the family to accrue the knowledge, confidence and skills to manage his condition. [6]. In this sense, nursing care should be adjusted to advocate individual capacities of patients, promoting personal autonomy and empowerment.…”

“…When using ICT in health care, the partnership between the patient and the professionals is crucial, where the self-management means that the people with chronic diseases become the managers of their own condition and the health care professionals are taken for "consultors" supporting them in these roll. ICT is considered an important facilitator of such partnerships but, above all, it does not only helps patients and their families to increase their knowledge and trust to manage their condition [6].…”

Guided or factual computer support for kidney patients with different experience levels and medical health situations: preferences and usage

“…These computer systems, referred to as self-management support systems (SMSSs), have shown beneficial effects for chronic diseases, such as heart diseases, chronic lung diseases, diabetes, and cardiovascular care [3][4][5]. Existing SMSSs provide various types of support, for example, providing a platform for patients to conduct self-monitoring of their health condition or daily life [4] For such SMSSs, it is expected that personalisation would make them more effective and easier to accept [6]. Various aspects can be considered for personalisation when designing a SMSS, such as patient's age, education, interests, physical capabilities, familiarity, and access to technology [7].…”

Codesigned Shared Decision-Making Diabetes Management Plan Tool for Adolescents With Type 1 Diabetes Mellitus and Their Parents: Prototype Development and Pilot Test (Preprint)

“…Shared decision making in person-centered care is a process in which clinicians and patients work together to make decisions and select care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values. [7] Diabetes self-care goals outlined with the diabetes care team in the form of "behavioral contracts" have been used to address: (1) goals for frequency of SMBG; (2) goals for frequency of contact with the diabetes clinic team: and (3) parent and youth responsibilities. [3,[8][9][10] However, these "contracts" can be perceived as punitive if they are not constructed using patientcentered communication as adolescents can be sensitive to authoritarian treatment.…”