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

Abstract

Background The COVID-19 pandemic brought social, economic, and health impacts, requiring fast adaptation of health systems. Although information and communication technologies were essential for achieving this objective, the extent to which health systems incorporated this technology is unknown. Objective The aim of this study was to map the use of digital health strategies in primary health care worldwide and their impact on quality of care during the COVID-19 pandemic. Methods We performed a scoping review based on the Joanna Briggs Institute manual and guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. A systematic and comprehensive three-step search was performed in June and July 2021 in multidisciplinary health science databases and the gray literature. Data extraction and eligibility were performed by two authors independently and interpreted using thematic analysis. Results A total of 44 studies were included and six thematic groups were identified: characterization and geographic distribution of studies; nomenclatures of digital strategies adopted; types of information and communication technologies; characteristics of digital strategies in primary health care; impacts on quality of care; and benefits, limitations, and challenges of digital strategies in primary health care. The impacts on organization of quality of care were investigated by the majority of studies, demonstrating the strengthening of (1) continuity of care; (2) economic, social, geographical, time, and cultural accessibility; (3) coordination of care; (4) access; (5) integrality of care; (6) optimization of appointment time; (7) and efficiency. Negative impacts were also observed in the same dimensions, such as reduced access to services and increased inequity and unequal use of services offered, digital exclusion of part of the population, lack of planning for defining the role of professionals, disarticulation of actions with real needs of the population, fragile articulation between remote and face-to-face modalities, and unpreparedness of professionals to meet demands using digital technologies. Conclusions The results showed the positive and negative impacts of remote strategies on quality of care in primary care and the inability to take advantage of the potential of technologies. This may demonstrate differences in the organization of fast and urgent implementation of digital strategies in primary health care worldwide. Primary health care must strengthen its response capacity, expand the use of information and communication technologies, and manage challenges using scientific evidence since digital health is important and must be integrated into public service.

Innovations in Modern Medicine and Biology

“…Quality in of health care is considered as a multidimensional concept, which includes a dynamic continuous process of providing medical service to patients by health care institutions, in particular, by primary health care centers (PHC), aiming to meet the medical needs of the population. High-quality medical care also involves effective, safe and rational use of resources, as per medical standards, as well as reducing costs in the health care system [332][333].…”

“Talking on the Phone Is Very Cold”—Primary Health Care Nurses’ Approach to Enabling Patient Participation in the Context of Chronic Diseases during the COVID-19 Pandemic

“…At the same time, technical innovations, such as remote care in the form of remote consultations or patient monitoring via telephone and video conferencing, entered PHC at an unprecedented pace to sustain service delivery and the ability to meet patients’ needs [ 14 , 19 , 20 ]. However, studies indicate that these solutions have positive, as well as negative, impacts on the quality of care.…”

“…However, studies indicate that these solutions have positive, as well as negative, impacts on the quality of care. In a literature review, Silva et al [ 20 ] refer to studies that point out the positive impacts of telehealth consultations. According to these studies, digital communication and telehealth positively impact the establishment of trust and bonds between patients and health professionals, which facilitates patient participation.…”

“…Furthermore, respect between professionals and patients improved when using these digital solutions. However, there is also evidence of negative impacts on communication, e.g., through the loss of nonverbal communication or insecurity [ 20 ].…”

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

“…Faced with the challenges in PHC from COVID-19, the use of Information and Communication Technologies gained even more prominence due to the operability and versatility of generating information at an opportune time (12,13,14). Digital health assists healthcare workers in diagnosing, monitoring, and communicating with older adult patients around the world, especially during the COVID-19 pandemic (15).…”