The challenge of involving elderly patients in primary care by using an electronic communication tool with their professionals: a mixed methods study

Abstract

Background Elderly patients in primary care often have multiple health problems, with different healthcare professionals involved. For consistency in care, it is required that communication amongst professionals and patient-systems (patient and informal-carers) be well tuned. Electronic-communication can make it easier for patient-system to be active in care. Objective To examine whether an e-communication tool (Congredi) designed for professionals, including a care plan and secure e-mail, is usable for patient-systems and what their experiences are. Methods In a multi-method study, home-dwelling elderly patients with two or more professionals were invited to use Congredi; data were gathered from the system after 42 weeks. Also semi-structured interviews were undertaken with patient-systems with topics retrieved from literature. Analysis took place by two researchers independently; the themes were extracted together by consensus. Results Data about actual use of the tool were gathered from 22 patients. Four profiles of Congredi-users were distinguished, varying in intensity of use. Data from interviews with members of patient-systems (n = 7) showed that they were motivated and able to use Congredi. Barriers in daily use were limited participation of professionals, unanswered e-mail and not being alerted about actions. Despite limitations, patient-systems retained their motivation. Conclusion Congredi was usable for patient-systems. The barriers found seem not to be tool-related but primarily user-related. An important barrier for daily use was limited active participation of involved professionals in a complete feedback loop. Potential for future implementation was found, as patient-systems were intrinsically motivated for better feedback with the professionals, even though in this study it only partly met their expectations.

Ageism in healthcare technology: the older patients’ aspirations for improved online accessibility

“… 17 , 18 Providers have been shown to play a significant role in alleviating anxiety related to portals use and increased compliance when encouraged as such. 19 Addressing the anxiety barrier attributed to new technology must be tackled by healthcare systems through development of age-appropriate educational material addressing their concerns and technical support available. Additionally, personnel must be familiarized with age-appropriate guidance.…”

Implementation of interprofessional digital communication tools in primary care for frail older adults: An interview study

“…Many information and communications technology (ICT) tools for interprofessional settings are still too fragmented in their functionalities or complex to use (Matthew-Maich et al, 2016 ; Svensson, 2019 ). Studies on the use and effects of interprofessional tools are still scarce and refer to tools that were not frequently used (de Jong et al, 2017 ; Makai et al, 2014 ; Robben et al, 2012 ). Moreover, these tools were only individually evaluated and an overview of common implementation facilitators and barriers is missing.…”

Efficacy of a Telemonitoring System as a Complementary Strategy in the Treatment of Patients With Heart Failure

“…11 For these systems to be effective, the literature suggests that they should incorporate a Complete Feedback Loop (CFL). 12 This CFL comprises a five-stage communicative process, involving both healthcare professionals and patient systems playing an active role. These stages are as follows: (1) conveying data and information about the health status of patients, (2) analyzing the data and information with the help of existing knowledge or wisdom and applying evidence-based standards, (3) addressing the unique needs of each patient, (4) providing prompt feedback to the patient that addresses their specific needs, and (5) routinely repeating the CFL.…”

“…For these systems to be effective, the literature suggests that they should incorporate a Complete Feedback Loop (CFL) 12 . This CFL comprises a five-stage communicative process, involving both healthcare professionals and patient systems playing an active role.…”