Digital Health Transformation of Integrated Care in Europe: Overarching Analysis of 17 Integrated Care Programs.

Erik Baltaxe,Isaac Cano,Oscar Solans,Maureen Rutten-Van Molken,Renata Grenkovic,Jan Erik Askildsen,Tord Skogedal Lindén,Miriam Reiss,Jonathan Stokes,Thomas Czypionka,Verena Struckmann,Markus Kraus,Josep Roca,János György Pitter

doi:10.2196/14956

Abstract

BackgroundDigital health tools comprise a wide range of technologies to support health processes. The potential of these technologies to effectively support health care transformation is widely accepted. However, wide scale implementation is uneven among countries and regions. Identification of common factors facilitating and hampering the implementation process may be useful for future policy recommendations.ObjectiveThe aim of this study was to analyze the implementation of digital health tools to support health care and social care services, as well as to facilitate the longitudinal assessment of these services, in 17 selected integrated chronic care (ICC) programs from 8 European countries.MethodsA program analysis based on thick descriptions—including document examinations and semistructured interviews with relevant stakeholders—of ICC programs in Austria, Croatia, Germany, Hungary, the Netherlands, Norway, Spain, and the United Kingdom was performed. A total of 233 stakeholders (ie, professionals, providers, patients, carers, and policymakers) were interviewed from November 2014 to September 2016. The overarching analysis focused on the use of digital health tools and program assessment strategies.ResultsSupporting digital health tools are implemented in all countries, but different levels of maturity were observed among the programs. Only few ICC programs have well-established strategies for a comprehensive longitudinal assessment. There is a strong relationship between maturity of digital health and proper evaluation strategies of integrated care.ConclusionsNotwithstanding the heterogeneity of the results across countries, most programs aim to evolve toward a digital transformation of integrated care, including implementation of comprehensive assessment strategies. It is widely accepted that the evolution of digital health tools alongside clear policies toward their adoption will facilitate regional uptake and scale-up of services with embedded digital health tools.

Highlights

BackgroundDigital health tools have been proposed to improve access to health care services, enhance care co-ordination and integration, enable self-management, support decision-making, enable monitoring, perform risk analysis, and facilitate proactive interventions [1]
Supporting digital health tools are implemented in all countries, but different levels of maturity were observed among the programs
Notwithstanding the heterogeneity of the results across countries, most programs aim to evolve toward a digital transformation of integrated care, including implementation of comprehensive assessment strategies

Summary

Introduction

Digital health (eHealth) tools have been proposed to improve access to health care services, enhance care co-ordination and integration, enable self-management, support decision-making, enable monitoring, perform risk analysis, and facilitate proactive interventions [1]. It is within this context that the European Commission has defined eHealth as follows: The use of Information and Communication Technologies in health products, services and processes, combined with organizational change in health care systems and new skills, in order to improve health of citizens, efficiency and productivity in health care delivery, and the economic and social value of health [2]. Identification of common factors facilitating and hampering the implementation process may be useful for future policy recommendations

Methods

Results

Discussion

Conclusion