Towards the Development of an Integrated Care Platform for Frail Older Adults: Setting the Technological Priorities from a Stakeholder Perspective

Malavasi, Massimiliano; Fiordelmondo, Valentina; Hoogerwerf, Evert-Jan; Maluccelli, Lorenza; Desideri, Lorenzo; Doyle, Julie; Dinsmore, John

doi:10.1007/978-3-030-04672-9_12

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Of the 77 studies included, a total of 36 ICT-based integrated care practice models were included, of which only eight explicitly specified the rationale for their construction [ 17 18 19 20 21 22 23 24 ], with the Chronic Care Model (CCM) being used six times [ 17 18 19 20 21 22 ]. The 77 studies included 16 quasi-experimental studies [ 21 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 ], 11 randomized controlled trials [ 19 40 41 42 43 44 45 46 47 48 49 ], 10 cluster randomized controlled trials [ 17 24 50 51 52 53 54 55 56 57 ], 6 descriptive studies [ 58 59 60 61 62 63 ], 9 qualitative studies [ 18 23 64 65 66 67 68 69 70 ], 4 retrospective cohort studies [ 71 72 73 74 ], 5 working papers [ 75 76 77 78 ...…”

Section: Resultsmentioning

confidence: 99%

“…Delmastro [ 59 ] and Piera-Jimenez [ 38 ] used smart medical devices and sensors to collect health data on older adults. Malavasi [ 67 ] and Doyle [ 91 ] used a color-coded traffic light system in an app to customize health and well-being data reports for older adults and to send alerts and push messages when values were abnormal.…”

Section: Core Elements Of Ict-based Implementation Of Integrated Carementioning

confidence: 99%

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Information and Communication Technology Based Integrated Care for Older Adults: A Scoping Review

Yutong¹,

Yan²,

Qingyun³

et al. 2023

Int J Integr Care

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Background: Integrated care is an important initiative to respond positively to the ageing of society and information and communication technology(ICT) plays an important role in facilitating the integration of functional and normative health and social care. The scoping review aims to synthesize evidence on the experience and practice of ICT-based implementation of integrated care for older adults. Methods: This study followed the research framework developed by Arksey and O’malley for the scoping review and systematically searched for relevant studies published between 1 January 2000 and 30 March 2022 from nine electronic databases, three specialist journals, three key institutional websites, 11 integrated care project websites, google scholar and references of the studies to be included. Two reviewers independently screened and extracted data and used thematic analysis to sort out and summarize the core elements, hindrances and facilitators of ICT-based integrated care. Results: A total of 77 studies were included in this study, including 36 ICT-based practice models of integrated care with seven core elements of implementation including single entry point, comprehensive geriatric assessment, personalized care planning, multidisciplinary case conferences, coordinated care, case management and patient empowerment, which generally had a positive effect on improving quality of life, caregiver burden and primary care resource utilization for older adults, but effectiveness evaluations remained Heterogeneity exists. The barriers and facilitators to ICT-based implementation of integrated care were grouped into four themes: demand-side factors, provider factors, technology factors and system factors. Conclusion: The implementation of ICT-based integrated care for the elderly is expected to improve the health status of both the supply and demand of services, but there is still a need to strengthen the supply of human resources, team training and collaboration, ICT systems and financial support in order to promote the wider use of ICT in integrated care.

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Section: Resultsmentioning

confidence: 99%

Section: Core Elements Of Ict-based Implementation Of Integrated Carementioning

confidence: 99%

Information and Communication Technology Based Integrated Care for Older Adults: A Scoping Review

Yutong¹,

Yan²,

Qingyun³

et al. 2023

Int J Integr Care

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A Digital Health Platform for Integrated and Proactive Patient-Centered Multimorbidity Self-management and Care (ProACT): Protocol for an Action Research Proof-of-Concept Trial

Dinsmore¹,

Hannigan²,

Smith³

et al. 2021

JMIR Res Protoc

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Background Multimorbidity is defined as the presence of two or more chronic diseases and associated comorbidities. There is a need to improve best practices around the provision of well-coordinated, person-centered care for persons with multimorbidities. Present health systems across the European Union (EU) focus on supporting a single-disease framework of care; the primary challenge is to create a patient-centric, integrated care ecosystem to understand and manage multimorbidity. ProACT is a large-scale project funded by the European Commission under the Horizon 2020 programme, that involved the design, development, and evaluation of a digital health platform to improve and advance home-based integrated care, and supported self-management, for older adults (aged ≥65 years) living with multimorbidity. Objective This paper describes the trial implementation protocol of a proof-of-concept digital health platform (ProACT) in 2 EU member states (Ireland and Belgium) to support older persons with multimorbidities self-managing at home, supported by their care network (CN). Methods Research was conducted across 2 EU member states, Ireland and Belgium. A 12-month action research trial design, divided into 3 evaluation cycles and lasting 3 months each, with a reflective redesign and development phase of 1 month after cycles 1 and 2 was conducted. Participants were 120 (60/120, 50% in Ireland and 60/120, 50% in Belgium) older persons with multimorbidities diagnosed with two or more of the following chronic conditions: diabetes, chronic obstructive pulmonary disease, chronic heart failure, and cardiovascular diseases. With permission from persons with multimorbidities, members of their CN were invited to participate in the study. Persons with multimorbidities were provided with ProACT technologies (tablet, devices, or sensors) to support them in self-managing their conditions. CN members also received access to an app to remotely support their persons with multimorbidity. Qualitative and quantitative feedback and evaluation data from persons with multimorbidity and CN participants were collected across four time points: baseline (T1), at the end of each 3-month action research cycle (T2 and T3), and in a final posttrial interview (T4). Thematic analysis was used to analyze the qualitative interview data. Quantitative data were analyzed via platform use statistics (to assess engagement) and standardized questionnaires (using descriptive and inferential statistics). This study is approved by the ethics committees of Ireland and Belgium. Results The trial implementation phase for this 44-month (2016-2019) funded study was April 2018 to June 2019. The trial outcomes are at various stages of publication since 2021. Conclusions ProACT aims to co-design and develop a digital intervention with persons with multimorbidities and their CN, incorporating clinical guidelines with the state of the art in human-computer interaction, behavioral science, health psychology, and data analytic methods to deliver a digital health platform to advance self-management of multimorbidity at home, as part of a proactive, integrated model of supported person-centered care. International Registered Report Identifier (IRRID) RR1-10.2196/22125

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A Digital Health Platform for Integrated and Proactive Patient-Centered Multimorbidity Self-management and Care (ProACT): Protocol for an Action Research Proof-of-Concept Trial (Preprint)

Dinsmore¹,

Hannigan²,

Smith³

et al. 2020

Preprint

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BACKGROUND Multimorbidity is defined as the presence of two or more chronic diseases and associated comorbidities. There is a need to improve best practice around the provision of well-coordinated, person-centred care for persons with multimorbidity (PwMs). Present health systems across the European Union (EU) focus on supporting a single disease framework of care; the primary challenge is to create a patient centric integrated care ecosystem to understand and manage multimorbidity. ProACT is a large-scale Horizon 2020 funded project, that involved the design, development and evaluation of a digital health platform to improve and advance home-based integrated care, and supported self-management, for older adults (aged 65+) living with multimorbidity. OBJECTIVE This paper describes the trial implementation protocol of a proof of concept (PoC) digital health platform (ProACT) in two EU member states (Ireland and Belgium) to support older persons with multimorbidity self-managing at home, supported by their care network. METHODS Research was conducted across two EU member states, Ireland and Belgium. A twelve month action research trial design, divided into three evaluation cycles, lasting three months each, with a reflective re-design phase of one month after cycles 1 and 2 was conducted. Participants were 120 (n=60 in Ireland and Belgium respectively) older persons with multimorbidity (PwMs) diagnosed with two or more of the following chronic conditions: diabetes; chronic obstructive pulmonary disease (COPD); chronic heart failure (CHF); cardiovascular diseases (CVDs). With permission from the PwM, members of their care network (CN) were invited to participate in the study. PwM participants were provided with ProACT technologies (tablet/devices/sensors) to support them in self-managing their conditions. CN members also received access to an application to remotely support their PwM. Qualitative and quantitative feedback and evaluation data from PwM and CN participants was collected across 4 time-points: baseline (T1); at the end of each 3-month action research cycle (T2; T3) and in a final post-trial interview (T4). Thematic analysis was used to analyse qualitative interview data. Quantitative data were analysed via platform usage statistics (to assess engagement) and standardised questionnaires (using descriptive and inferential statistics). This study was approved by ethics committees in Ireland and Belgium. RESULTS The trial implementation phase for this 44 month (2016-2019) funded study was April 2018 to June 2019. Trial outcomes are being submitted for publication in 2020. CONCLUSIONS ProACT aims to co-design and develop a digital intervention with PwMs and their CN, incorporating clinical guidelines with the state of the art in; human computer interaction, behavioural science, health psychology and data analytic methods to deliver a digital health platform to advance self-management of multimorbidity at home, as part of a proactive integrated model of supported person-centred care.

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Towards the Development of an Integrated Care Platform for Frail Older Adults: Setting the Technological Priorities from a Stakeholder Perspective

Cited by 3 publications

References 6 publications

Information and Communication Technology Based Integrated Care for Older Adults: A Scoping Review

Information and Communication Technology Based Integrated Care for Older Adults: A Scoping Review

A Digital Health Platform for Integrated and Proactive Patient-Centered Multimorbidity Self-management and Care (ProACT): Protocol for an Action Research Proof-of-Concept Trial

A Digital Health Platform for Integrated and Proactive Patient-Centered Multimorbidity Self-management and Care (ProACT): Protocol for an Action Research Proof-of-Concept Trial (Preprint)

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