An eHealth Platform to Manage Chronic Disease in Primary Care: An Innovative Approach

Talboom-Kamp, Esther; Verdijk, Noortje A; Harmans, L.; Numans, Mattijs E.; Chavannes, Niels H.

doi:10.2196/ijmr.4217

Cited by 41 publications

(32 citation statements)

References 44 publications

(46 reference statements)

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“…The application of mHealth solutions can support the provision of high-quality care to patients with chronic respiratory diseases such as asthma. It can provide satisfaction for both patients and healthcare professionals, and reduce healthcare consumption and costs [3]. However, it is increasingly being recognised that implementing ICT innovations may also have adverse consequences.…”

mentioning

confidence: 99%

Realising the potential of mHealth to improve asthma and allergy care: how to shape the future

Bousquet¹,

Chavannes²,

Guldemond³

et al. 2017

Eur Respir J

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mentioning

confidence: 99%

Realising the potential of mHealth to improve asthma and allergy care: how to shape the future

Bousquet¹,

Chavannes²,

Guldemond³

et al. 2017

Eur Respir J

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“…Implementing mHealth innovations may also have disruptive consequences [ 15 ], so it is important to test applicability in each individual situation [ 16 ]. A rapid growth of the health apps market has been seen with an estimated 325,000 health apps available in 2017 for most fields of medicine [ 17 ]. Benefits and drawbacks have been estimated for a number of disease [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence

Bousquet¹,

Arnavielhe²,

Bedbrook³

et al. 2018

Clin Transl Allergy

122

154

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mHealth, such as apps running on consumer smart devices is becoming increasingly popular and has the potential to profoundly affect healthcare and health outcomes. However, it may be disruptive and results achieved are not always reaching the goals. Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline using the best evidence-based approach to care pathways suited to real-life using mobile technology in allergic rhinitis (AR) and asthma multimorbidity. Patients largely use over-the-counter medications dispensed in pharmacies. Shared decision making centered around the patient and based on self-management should be the norm. Mobile Airways Sentinel networK (MASK), the Phase 3 ARIA initiative, is based on the freely available MASK app (the Allergy Diary, Android and iOS platforms). MASK is available in 16 languages and deployed in 23 countries. The present paper provides an overview of the methods used in MASK and the key results obtained to date. These include a novel phenotypic characterization of the patients, confirmation of the impact of allergic rhinitis on work productivity and treatment patterns in real life. Most patients appear to self-medicate, are often non-adherent and do not follow guidelines. Moreover, the Allergy Diary is able to distinguish between AR medications. The potential usefulness of MASK will be further explored by POLLAR (Impact of Air Pollution on Asthma and Rhinitis), a new Horizon 2020 project using the Allergy Diary.

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“…Subsequently, it has been approached in different ways in various studies. Sometimes, value has been investigated as positive outcomes such as clinical efficacy or behavior change of patients or professionals [ 4 , 5 ]. Others have aimed to identify value through the perceptions of various stakeholders [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying the Value of an eHealth Intervention Aimed at Cognitive Impairments: Observational Study in Different Contexts and Service Models

Jurkeviciute¹,

Velsen²,

Eriksson³

et al. 2020

J Med Internet Res

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Background Value is one of the central concepts in health care, but it is vague within the field of summative eHealth evaluations. Moreover, the role of context in explaining the value is underexplored, and there is no explicit framework guiding the evaluation of the value of eHealth interventions. Hence, different studies conceptualize and operationalize value in different ways. Objective The objective of our study is to identify contextual factors that determine similarities and differences in the value of an eHealth intervention between 2 contexts. We also aim to reflect on and contribute to the discussion about the specification, assessment, and relativity of the “value” concept in the evaluation of eHealth interventions. Methods The study concerned a 6-month eHealth intervention targeted at elderly patients (n=107) diagnosed with cognitive impairment in Italy and Sweden. The intervention introduced a case manager role and an eHealth platform to provide remote monitoring and coaching services to the patients. A model for evaluating the value of eHealth interventions was designed as monetary and nonmonetary benefits and sacrifices, based on the value conceptualizations in eHealth and marketing literature. The data was collected using the Mini–Mental State Examination (MMSE), the clock drawing test, and the 5-level EQ-5D (EQ-5D-5L). Semistructured interviews were conducted with patients and health care professionals. Monetary data was collected from the health care and technology providers. Results The value of an eHealth intervention applied to similar types of populations but differed in different contexts. In Sweden, patients improved cognitive performance (MMSE mean 0.85, SD 1.62, P<.001), reduced anxiety (EQ-5D-5L mean 0.16, SD 0.54, P=.046), perceived their health better (EQ-5D-5L VAS scale mean 2.6, SD 9.7, P=.035), and both patients and health care professionals were satisfied with the care. However, the Swedish service model demonstrated an increased cost, higher workload for health care professionals, and the intervention was not cost-efficient. In Italy, the patients were satisfied with the care received, and the health care professionals felt empowered and had an acceptable workload. Moreover, the intervention was cost-effective. However, clinical efficacy and quality of life improvements have not been observed. We identified 6 factors that influence the value of eHealth intervention in a particular context: (1) service delivery design of the intervention (process of delivery), (2) organizational setup of the intervention (ie, organizational structure and professionals involved), (3) cost of different treatments, (4) hourly rates of staff for delivering the intervention, (5) lifestyle habits of the population (eg, how physically active they were in their daily life and if they were living alone or with family), and (6) local preferences on the quality of patient care. Conclusions Value in the assessments of eHealth interventions need to be considered beyond economic terms, perceptions, or behavior changes. To obtain a holistic view of the value created, it needs to be operationalized into monetary and nonmonetary outcomes, categorizing these into benefits and sacrifices.

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An eHealth Platform to Manage Chronic Disease in Primary Care: An Innovative Approach

Cited by 41 publications

References 44 publications

Realising the potential of mHealth to improve asthma and allergy care: how to shape the future

Realising the potential of mHealth to improve asthma and allergy care: how to shape the future

MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence

Identifying the Value of an eHealth Intervention Aimed at Cognitive Impairments: Observational Study in Different Contexts and Service Models

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