Abstract
Background: Provision of care to patients with chronic diseases at their homes remains a great challenge for modern health care systems. Smartphone applications are indicated as one of the strategies that could improve care delivery to this group of patients. The aim of this study is to investigate the feasibility and usability of a proprietary application with a messaging service used by a primary care team attending chronic patients mainly at their homes.
 Methods: A Cross-sectional pilot study of a smartphone application to communicate amongst clinicians. Primary care practices in Tona, Spain, were recruited during a period from January to December 2016. Clinicians used WhatsICS to communicate during their home visits for 12 months. We studied the patterns of use, response time and types of communication. To explore barriers and enablers, semi-structured interviews were conducted with selected nurses, social worker and general practitioners.
 Results: Two nurses, two practitioners and a social worker were recruited and more than 1,000 hours of communication were recorded on 163 patients, generating 5820 communication events. Nurses initiated the majority of communications (59.79%); these communications were mainly for the purpose of receiving instructions from practitioners and for coordination (66.6%). The communications were made on weekdays, from Monday to Friday, and between 7:30 a.m. and 9:30 p.m. (99.73%). Participants felt that WhatsICS helped streamline and improve home-based care.
 Conclusions: WhatsICS is safe technologically and accepted as a communication tool for professionals. This study establishes the basis for future implementations of this tool to improve the care of chronic patients at home through smartphones.
Highlights
The care of chronically ill patients has become a major issue for health care systems of developed countries, which by their design, are not prepared enough to deal with the demand that these patients are generating and will generate, even more, in the future [1]
This study establishes the basis for future implementations of this tool to improve the care of chronic patients at home through smartphones
This study aims to evaluate, for the first time, the use of WhatsICS, a proprietary application that facilitates a technologically secure communication among members of a multidisciplinary team that cares for chronic patients at home
Summary
The care of chronically ill patients has become a major issue for health care systems of developed countries, which by their design, are not prepared enough to deal with the demand that these patients are generating and will generate, even more, in the future [1]. Initiatives have emerged to reform the type of care provided to the chronically ill, with a new structured, proactive and multidisciplinary approach, based on primary care and supported by a range of specialists, including geriatricians, community nurses, mental health and rehabilitation professionals; working in partnership with caregivers and social care professionals and sharing information, assessments, policies, training and learning [7,8,9]. While those technologies can greatly facilitate the care of the chronically ill, the communication methods used by health professionals often evokes to a period before the introduction of smartphones and social networks. The aim of this study is to investigate the feasibility and usability of a proprietary application with a messaging service used by a primary care team attending chronic patients mainly at their homes
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