E-health Applications and Services for Patient Empowerment: Directions for Best Practices in The Netherlands

Abstract

Objective: E-health may enable the empowerment process for patients, particularly the chronically ill. However, e-health is not always designed with the requirements of patient empowerment in mind. Drawing on evidence-based e-health studies, we propose directions for best practices to develop e-health that promotes patient empowerment. Methods: The concept of patient empowerment in the Dutch setting is discussed first. The prerequisites for patient empowerment are then described and translated into empowerment areas relevant to e-health. Materials: We reviewed Dutch e-health studies that provide insights into what works, and what does not, in e-health. Results: On the basis of the lessons learned from the studies, we propose directions for best practices to develop e-health that promotes patient empowerment. These directions cover various aspects, such as the design and implementation of e-health, its information content and usability, awareness, and acceptance. The studies also indicate the difficulty of establishing that e-health is really dedicated to patient empowerment. Conclusions: Despite the body of knowledge about patient empowerment, as well as the technological visibility of e-health, evidence for best practices in general and for patient empowerment in particular is scarce. We call for a more systematic evaluation of e-health for patient empowerment and more reliable evidence. Beyond the organizational and technical issues involved in e-health, there is also a need to demonstrate its practical benefits to patients. The Netherlands is active in developing sustainable e-health. National initiatives are now in place to support the processes with the aim of establishing the required evidence-based best practices.

Perceptions of Persons With Type 2 Diabetes Treated in Swedish Primary Health Care: Qualitative Study on Using eHealth Services for Self-Management Support (Preprint)

“…Our findings support previous studies, which report that empowerment can be improved by using digitized approaches in healthcare [5,37,41]. Empowerment implies participation and responsibility through increased awareness and knowledge [42].…”

“…Alpay et al [37] concluded that in removing barriers of time and geographical distance in healthcare services -by use of digital and technological services such as video consultations and telehealth -the patients gain flexibility. They get an easier and more convenient access to healthcare, they may even have fewer time-demanding healthcare centre visits, and finally, patients can receive care at a location that does not require transportation, and in an environment that can be experienced as less threatening.…”

“…Empowerment implies participation and responsibility through increased awareness and knowledge [42]. Selfefficacy is an important aspect of empowerment and relates to change in behaviour [43], which is important for self-management in chronic conditions [37].…”

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“…In an evaluation process of the empowerment process, the evaluation of community empowerment can be based on the calculation of individual empowerment. 9 In this sense, professional training aims to train professionals capable of stimulating the local population to act effectively on their living conditions and health and be aware of their rights and how to reach it. Monte Negro has a high percentage of population living in rural areas (60%), and this population cannot easily shift to the city, which happens sporadically, so the education of the CHW is paramount to conducting an active study of the health needs of this population as well as to conduct health promotion activities targeted to their needs.…”

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“…That is, their systems can also function as e-Health technology [19] by functioning as an eCoach (see e.g., [20]), and help users adapt their behavior. Such technology would be Persuasive Technology [1][2][3], as it attempts to change user behavior or attitudes without coercion or deception [1,24].…”