Digital technologies in primary care: Implications for patient care and future research

Abstract

Digital health is the convergence of digital technologies with health, healthcare, living, and society. Contrasting with the slow trend during the last decades, in the last few years, we have observed an expansion and widespread adoption and implementation. In this paper, we revisit the potential that digital health presents for the delivery of higher quality, safer and more equitable care. Focussing on three examples – patient access to health records, big data analytics, and virtual care – we discuss the emerging opportunities and challenges of digital health, and how they can change primary care. We also reflect on the implications for research to evaluate digital interventions: the need to evaluate clear outcomes in light of the six dimensions of quality of care (patient-centredness, efficiency, effectiveness, safety, timeliness, and equity); to define clear populations to understand what works and for which patients; and to involve different stakeholders in the formulation and evaluation of the research questions. Finally, we share five wishes for the future of digital care in General Practice: the involvement of primary healthcare professionals and patients in the design and maintenance of digital solutions; improving infrastructure, support, and training; development of clear regulations and best practice standards; ensuring patient safety and privacy; and working towards more equitable digital solutions, that leave no one behind.

Clinical trials in primary care: bridging the gap between evidence-based recommendations and clinical practice

“…6 Researchers in primary care should consider that physical, behavioral, and social health are all intertwined, and thus achieving desirable outcomes may require complex interventions DOI: 10.32385/rpmgf.v38i5.13609 care, virtual monitoring, and self-care training for consideration in future research planning. [14][15][16][17] Complex interventions may incorporate main primary care characteristics, including the patient's first contact with the health care system, continuity, integration, and coordination of services. [18][19] Specific RCT designs including pragmatic, cluster or stepped-wedged trials may also be necessary to appropriately evaluate these interventions and ensure generalizability.…”

Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

“…Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients [ 1 , 2 , 3 ]. The COVID-19 pandemic has brought to light all the fragility of health systems: the geographical and socio-economic disparities in accessing services and benefits, waiting times that are often too long to carry out examinations and specialist visits and the poor integration between the hospital system and medicine on the territory [ 4 , 5 ].…”

Artificial intelligence enabled conversational agent for mental healthcare

“…Globally, mental health issues are becoming more prevalent nowadays. One in every four people, as reported by the World Health Organization (WHO), deals with a mental disease at some point in their lives (Neves & Burgers, 2022). Around the world, mental illness continues to be the main contributor to the financial difficulty associated with health (Lazarus et al, 2022;Vigo et al, 2016;Hwong et al, 2022).…”

“…Despite the rising prevalence of mental illnesses, it is alarming to note that there are a shockingly low number of mental health experts around the globe (9 per 100,000), particularly in Southeast Asia (2.5 per 100,000) (Maheswari, 2022). Although there are effective and well-established treatments for many illnesses, just around half of those who are affected obtain them (Neves & Burgers, 2022). The primary barriers to effective treatment have been identified as a lack of funding, a dearth of skilled medical personnel, and the stigma associated with mental illnesses (Neves & Burgers, 2022).…”

“…Although there are effective and well-established treatments for many illnesses, just around half of those who are affected obtain them (Neves & Burgers, 2022). The primary barriers to effective treatment have been identified as a lack of funding, a dearth of skilled medical personnel, and the stigma associated with mental illnesses (Neves & Burgers, 2022). To provide people who are harmed with accessible, economical, and evidence-based treatment, medical practices are under increasing public pressure worldwide (Juneau et al, 2022).…”