3M02 Can a digital intervention transform the cardiac care delivery model to patients aged over 65 in ireland?

Abstract

Background and Aim In Ireland the over 65 population is increasing by 20 000 people each year. Within older people, cardiovascular disease is the leading cause of death and the cost associated with treatment is increasing rapidly. Managing and preventing further deterioration of patients with chronic diseases is a health policy priority. Central to this, is the drive to empower patients to take much more control over their own care and treatment, aided by advances is technology. A digital intervention offers the potential to allow people to self-manage their chronic illness, adhere to treatment and avail of lifestyle changing advice outside the traditional health setting. Yet despite evidence of the role of technology in cardiovascular care, it has not been used to support the management and prevention of further deterioration of older adults living with cardiovascular diseases. Cardiac care in Ireland remains hospital centred and evidence suggest health professionals are concerned about the ability of technology to monitor patients’ conditions and adherence. This study will explore the introduction of a digital intervention by a cardiac team in the management of their patients with heart failure living at home. Methods This study is designed to understand work practices prior to the introduction of a digital intervention to identify and subsequently explore the emergence of and unfolding of new work practices and how these are (dis)connected from usual work practices. Direct observation of staff, questionnaires and semi structured interviews will be conducted in phase 1 to explore the existing working practices, system outcomes and job satisfaction of staff in a cardiac team. The baseline data stage is designed to provide a benchmark against which to compare changes at a later stage. In phase 2 (digital intervention), semi structured interviews will elicit understanding of staff roles and responsibilities, experiences/perspective on the use of technology. In phase 3, data will be analysed using the Normalization Process Theory framework to explore the social processes through which new practices, are reorganised, implemented and imbedded in practice. Conclusion Evidence suggests that a digital intervention can contribute to alleviate the increasing demands for care linked to chronic disease management, especially cardiac care. However, uptake of technology in care management remains low among health professionals and service users. In addition, there is a dearth of evidence on care providers’ perceptions of digital interventions and its clinical value in Ireland. This study is immersed in the implementation of a digital intervention. As such, it will yield valuable information from health professionals experiences and views on implementation of a digital intervention and how the tasks are handled over time [or not] and what this means for policymakers charged with planning for the needs of a growing older population living with chronic illnesses. This project is supported by the European Union’s INTERREG VA programme, managed by the Special EU Programmes Body (SEUPB).