SERIES: eHealth in primary care. Part 4: Addressing the challenges of implementation

Versluis, Anke; Luenen, Sanne van; Meijer, Eline; Honkoop, Persijn; Pinnock, Hilary; Mohr, David C.; Neves, Ana Luísa; Chavannes, Niels H.; Kleij, Rianne van der

doi:10.1080/13814788.2020.1826431

Cited by 43 publications

(35 citation statements)

References 24 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A few barriers should be addressed to allow home-based diagnostic testing in practice. An important barrier to eHealth adoption in primary care is, for example, the cost [ 71 ]. In the Netherlands, diagnostic tests ordered by a primary care physician are covered by health insurance.…”

Section: Discussionmentioning

confidence: 99%

Direct Access for Patients to Diagnostic Testing and Results Using eHealth: Systematic Review on eHealth and Diagnostics

Versluis¹,

Schnoor²,

Chavannes³

et al. 2022

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

Background The number of people with chronic diseases and the subsequent pressure on health care is increasing. eHealth technology for diagnostic testing can contribute to more efficient health care and lower workload. Objective This systematic review examines the available methods for direct web-based access for patients to diagnostic testing and results in the absence of a health care professional in primary care. Methods We searched the PubMed, Embase, Web of Sciences, Cochrane Library, Emcare, and Academic Search Premier databases in August 2019 and updated in July 2021. The included studies focused on direct patient access to web-based triage leading to diagnostic testing, self-sampling or testing, or web-based communication of test results. A total of 45 studies were included. The quality was assessed using the Mixed Methods Appraisal Tool. Results Most studies had a quantitative descriptive design and discussed a combination of services. Diagnostic test services mainly focused on sexually transmitted infections. Overall, the use was high for web-based triage (3046/5000, >50%, who used a triage booked a test), for self-sampling or self-testing kits (83%), and the result service (85%). The acceptability of the test services was high, with 81% preferring home-based testing over clinic-based testing. There was a high rate of follow-up testing or treatment after a positive test (93%). Conclusions The results show that direct access to testing and result services had high use rates, was positively evaluated, and led to high rates of follow-up treatment. More research on cost-effectiveness is needed to determine the potential for other diseases. Direct access to diagnostic testing can lower the threshold for testing in users, potentially increase efficiency, and lower the workload in primary care.

show abstract

Section: Discussionmentioning

confidence: 99%

Direct Access for Patients to Diagnostic Testing and Results Using eHealth: Systematic Review on eHealth and Diagnostics

Versluis¹,

Schnoor²,

Chavannes³

et al. 2022

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Applications like SkinVision could radically change the diagnostic process, require GPs to have a basic understanding of AI and therefore have a greater impact on daily GP practice. Clearly, the degree of disruption to a GP practice will form a barrier to using an eHealth application [ 9 ]. The greater the disruption, the greater the need for reliable testing of technical accuracy and clinical effectiveness.…”

Section: Discussionmentioning

confidence: 99%

“…24/7 telemonitoring of patients with diabetes rather than seeing them on a quarterly basis. The lessons learned from the first four papers in the eHealth series are relevant and important to all applications, especially in the case of more complex applications [1,[7][8][9]. Furthermore, patient factors are related to the complexity of applications and need to be considered.…”

Section: Aspects Concerning the Complexity Of Ehealth Applicationsmentioning

confidence: 99%

“…In the first four articles of this series on eHealth, we addressed issues related to the successful uptake and use of eHealth in primary care [1,[7][8][9]]. These issues were described from various perspectives ranging from ethical aspects to education and implementation, including the six preconditions that we view as pivotal to ensure safe, evidence-based and high-quality eHealth (Box 1).…”

Section: Introduction Ehealth In Primary Carementioning

confidence: 99%

See 1 more Smart Citation

SERIES: eHealth in primary care. Part 5: A critical appraisal of five widely used eHealth applications for primary care – opportunities and challenges

Kasteleyn

Versluis

Peet

et al. 2021

European Journal of General Practice

Self Cite

View full text Add to dashboard Cite

Background Given the pressure on modern healthcare systems, eHealth can offer valuable opportunities. However, understanding the potential and challenges of eHealth in daily practice can be challenging for many general practitioners (GPs) and their staff. Objectives To critically appraise five widely used eHealth applications, in relation to safe, evidence-based and high-quality eHealth. Using these applications as examples, we aim to increase understanding of eHealth among GPs and highlight the opportunities and challenges presented by eHealth. Discussion eHealth applications can support patients while increasing efficiency for GPs. A three-way division ( inform, monitor, track; interaction; data utilisation ) characterises many eHealth applications, with an increasing degree of complexity depending on the domain. All applications provide information and some have extra functionalities that promote interaction, while data analysis and artificial intelligence may be applied to support or (fully) automate care processes. Applications in the inform domain are relatively easy to use and implement but their impact on clinical outcomes may be limited. More demanding applications, in terms of privacy and ethical aspects, are found in the data utilisation domain and may potentially have a more significant impact on care processes and patient outcomes. When selecting and implementing eHealth applications, we recommend that GPs remain critical regarding preconditions on safe, evidence-based and high-quality eHealth, particularly in the case of more complex applications in the data utilisation domain.

show abstract

“…In a study implementing a precursor of the PHC in the Netherlands, a much higher response rate (70%) in underserved populations was achieved by a culturally adapted postal approach initiated by respondents’ GPs with a follow-up call to non-responders (Groenenberg et al, 2015 ). Research showed that, in general for optimal use of e-Health, different stakeholders such as patients, entrepreneurs, health care professionals and health care insurers should collaborate (Swinkels et al, 2018 ; Van der Kleij et al, 2018 ; Versluis et al, 2020 ). They should preferably be identified and involved at an early stage in the development and implementation of e-Health interventions (Nilsen et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

The Acceptance and Use of the e-Health Instrument ‘The Personal Health Check’ in Four Dutch Municipalities: Lessons Learned

et al. 2021

View full text Add to dashboard Cite

This pilot study assessed the acceptance and use of the e-Health instrument “the Personal Health Check” (PHC) among clients and professionals in primary care settings. By filling in the online PHC instrument, participants were provided insights into their health and lifestyle. When results revealed an increased health risk, participants were advised to undertake additional lab tests measuring blood pressure and haemaglobin levels. Based on the online questionnaire and optional lab tests, participants then received a report that included individually-tailored feedback from the e-Health application about personal health risks and suggestions for health interventions. The PHC was implemented in 2016 in four Dutch municipalities that determined which neighbourhood(s) the PHC targeted and how participants were invited. The Unified Theory of Acceptance and Use of Technology was used as a theoretical framework to address our research questions. Methods used to assess acceptance were: PHC instrument data, data from additional questionnaires completed by PHC participants, focus groups with PHC participants and professionals in primary care, and telephone interviews with non-responders to the invitation to participate in the online PHC. Of the 21,735 invited, 12% participated. Our results showed that participants and professionals in this pilot were predominantly positive about the PHC. Participants reported that they made an effort to apply the PHC lifestyle advice they received. Almost all had the knowledge and resources needed to use the PHC online instrument. Invitations from general practitioners almost doubled participation relative to invitations from the sponsoring municipalities. The overall low response rate, however, suggests that the PHC is unsuitable as a foundation on which to develop local public health policy.

show abstract

SERIES: eHealth in primary care. Part 4: Addressing the challenges of implementation

Cited by 43 publications

References 24 publications

Direct Access for Patients to Diagnostic Testing and Results Using eHealth: Systematic Review on eHealth and Diagnostics

Direct Access for Patients to Diagnostic Testing and Results Using eHealth: Systematic Review on eHealth and Diagnostics

SERIES: eHealth in primary care. Part 5: A critical appraisal of five widely used eHealth applications for primary care – opportunities and challenges

The Acceptance and Use of the e-Health Instrument ‘The Personal Health Check’ in Four Dutch Municipalities: Lessons Learned

Contact Info

Product

Resources

About