EHealth for elderly people with balance disorders and risk of falling. A mixed methods study

Abstract

Abstract Background The increasing life expectancy in Europe has not always been accompanied by an increase in healthy life expectancy. The burden of chronic diseases including balance disorders with risk of falling, and insufficient access to clinical data have led to a misuse of healthcare provision. Portuguese government have invested in digital heath, including electronic health record and eHealth services, as a strategy to relieve this pressure. However, the clinical applicability of eHealth devices in screening, assessing, and treating elderly people with balance disorders and risk of falling in Portugal is unknown. Objective This study aims at knowing how can the health systems use eHealth for more effective provision of care for elderly people with balance disorders and risk of falling. Methods An explanatory sequential mixed methods study was performed. From June to August 2019, an open questionnaire with 18 multiple choice questions was made available on the website of Portuguese General Medical Council. Subsequently, from December 2019 to April 2020, a qualitative study was conducted with semi-structured interviews. The eligible participants were physicians who provide healthcare to the elderly. Results 118 physicians responded to the questionnaire. 55% of the participants were dissatisfied or very dissatisfied with digital clinical availability and 61% with the time spent to access and to fill data. The eHealth was considered pertinent or very pertinent by 76% of the participants. Eight senior physicians discussed the constraints of data availability and pointed out strategies to improve clinical data and eHealth devices. Conclusions Despite the investments in digital health, there are still constraints contributing to the current misuse of care provision for elderly people with balance disorders. The use of eHealth was considered beneficial, but it should be improved further, and it should be considered for a more effective care delivery. Key messages In Portugal, there are still constraints contributing to the current misuse of care provision for elderly people with balance disorders. and risk of falling. The use of eHealth should be improved for a more effective provision of care.