Health Information Technology and Caregiver Interaction: Building Healthy Ecosystems

Abstract

This qualitative study explores the widely recognized role of the informal caregivers (ICGs) as key co-producers in the delivery of effective and sustainable healthcare systems. The central argument is that to enhance the quality of care in non-clinical settings and the healthcare ecosystem as a whole, developers of Health Information Technology (HIT) need to harness the knowledge and experiences of the ICGs to better align their products to practice. The paper has two aims: to improve the understandability of informal caregivers' role in non-traditional healthcare settings, and to identify and formulate valuable guidelines for the development of "fit for use" HIT solutions that acknowledge the needs of the ICGs.Health Information Technology is the application of information technology to health and healthcare. The fact that Health Information Technology ('HIT') brings together the management and computerization of health information with a wide range of stakeholders means it has far-reaching effects on the delivery and consumption of healthcare and health-related services [1: iv]. In this paper, HIT is defined as the use of information and communication technology (ICT) by formal (i.e., professional) and informal caregivers to deliver healthcare services in non-traditional settings. Basically, caregivers would combine the use of social media, collaborative platforms, online portals, bedside terminals, assistive technologies, handhelds, electronics, and electronic medical records into "effective means of accessing, communicating and storing information to improve patient care and population health, and reduce healthcare expenditures" [2: 476, 3, 4]. The sustained care of informal caregivers (ICGs) could enable people with chronic diseases, e.g., cancer [5], AIDS [6], Alzheimer's [7], stroke [8], Severe Multiple Sclerosis [9], and certainly the aging [10], to be assisted by family members either at the hospital or at home [11]. Nevertheless, to provide an effective care package, healthcare providers who enlist informal caregivers as active patient care partners [12] need to pay careful attention to the interactions between the ICGs, the healthcare professionals and the patients [13]. HIT has done much to make the informal caregivers part of healthcare service delivery ecosystems [14] but the evidence so far suggests that, overall, it is not enough to improve outcomes across the care continuum [2,15]. Prior studies have demonstrated significant advances in knowledge but uncertain improvements in skills [16] -in particular, in the training of disease management planning. The attitude of the healthcare provider to the ICG as a user of HIT is often the result of a mutual misunderstanding of needs [17,18]. On the other hand, the perception of the ICGs and care recipients is that they are at the mercy of the healthcare professionals.  MotivationThe difference between an informal caregiver (or family carer or caregiver, informal carer or care provider or caregiver) and a healthcare professional (e.g. clinical staff, nur...

Responding to COVID – 19: Insight Into Capability Re-Configuration of Healthcare Service Ecosystems? The Use Case of Hospitalization at Home

“…Starting from the recent advance in service research on H-SES, a number of reflections have been synthetized in terms of the actors' engagement and participation (Frow et al, 2019), including formal and informal caregiver interactions (Badr et al, 2018). Special attention has been given to the design and reconfiguration, adaptive processes, and the ability to face the emergence in the systems (Capunzo et al, 2013;Carrubbo et al, 2013;Ciasullo et al, 2017).…”

“…Effective solutions have been developed to manage the interaction among the care team (Badr et al, 2018), provide assistive functions (assistive technologies) and improve the patient's quality of life (Sofaer & Firminger, 2005;Moliner, 2009;Sweeney et al, 2015). Through the deployment of point of use systems and software based on principles of communication, data management, patient engagement has become key to the expansion of the H-SES (Britt et al, 2005;Gruman et al, 2010;.…”

Improving Interaction in Integrated Chronic Care Management

“…Recently, Badr and colleagues [24] extended Prahalad and Ramaswamy's original DART model and devised a set of principles for ICT solutions that promote interaction in the inner circles of the care team. Here, we borrow from this research work to underpin a set of principles for ICT solutions that align the feature functionality to the delivery system for integrated care.…”

“…A. Dialogue (D)) Mechanisms enabling integrated care for patients with chronic diseases depend on the use of ICT to enable support for coordination of care and information sharing between professionals and between organizations [24,25]; this includes the implementation of reminder systems, systems for information sharing and decision-making, and systems to provide an overview of the patient population. A sustainable and less inherently risky care-giving process must close the communication and information exchange gap between the formal and informal care teams in order to enable these to communicate continuously with the primary care providers.…”

“…Hence, in order to improve access to crucial information, ICT applications must provide access to data for the understanding of the course of disease and knowledge of treatment information [29]. These tools must be easy to use, with clear displays, visual aids and memory aids, and provide opportunities for training and support [24] with extensions to online assisted literacy resources [30]. Home-based assistive devices would be required to support the wider range of patient potential disabilities affecting their ability to use domotic technology [31].…”