Implementation of Digital Monitoring Services During the COVID-19 Pandemic for Patients With Chronic Diseases: Design Science Approach.

Luís Velez Lapão,Luís Velez Lapão,Luís Velez Lapão,Jorge Seixas,Jorge César Correia,Mariana Peyroteo,Mariana Peyroteo,Bruno Heleno,João Gregório,Melanie Maia,Melanie Maia,Miguel Mira Da Silva

doi:10.2196/24181

Abstract

BackgroundThe COVID-19 pandemic is straining health systems and disrupting the delivery of health care services, in particular, for older adults and people with chronic conditions, who are particularly vulnerable to COVID-19 infection.ObjectiveThe aim of this project was to support primary health care provision with a digital health platform that will allow primary care physicians and nurses to remotely manage the care of patients with chronic diseases or COVID-19 infections.MethodsFor the rapid design and implementation of a digital platform to support primary health care services, we followed the Design Science implementation framework: (1) problem identification and motivation, (2) definition of the objectives aligned with goal-oriented care, (3) artefact design and development based on Scrum, (4) solution demonstration, (5) evaluation, and (6) communication.ResultsThe digital platform was developed for the specific objectives of the project and successfully piloted in 3 primary health care centers in the Lisbon Health Region. Health professionals (n=53) were able to remotely manage their first patients safely and thoroughly, with high degrees of satisfaction.ConclusionsAlthough still in the first steps of implementation, its positive uptake, by both health care providers and patients, is a promising result. There were several limitations including the low number of participating health care units. Further research is planned to deploy the platform to many more primary health care centers and evaluate the impact on patient’s health related outcomes.

Highlights

Since the first case of COVID-19 was diagnosed in Wuhan, China in October 2019, the virus quickly spread around the world to become a global pandemic and a public health emergency, as declared by the World Health Organization in March 2020 [1]
Portugal has been severely affected by this pandemic, with 420,629 confirmed COVID-19 infections and 6972 deaths by the end of 2020 [3,4]; thanks to several important public health measures that were quickly put into place by health authorities, the situation was contained, and Portugal has been identified as a moderate success case in managing the pandemic [3]
The Portuguese health system benefits from its universal coverage and several public health units, which are strategically spread around the country, allowing easy access to care and facilitating contact tracing

Summary

Introduction

Since the first case of COVID-19 was diagnosed in Wuhan, China in October 2019, the virus quickly spread around the world to become a global pandemic and a public health emergency, as declared by the World Health Organization in March 2020 [1]. Portugal has been severely affected by this pandemic, with 420,629 confirmed COVID-19 infections and 6972 deaths by the end of 2020 [3,4]; thanks to several important public health measures (eg, closing schools, obligatory used of masks, broad application of testing, and closing of nonessential services) that were quickly put into place by health authorities, the situation was contained, and Portugal has been identified as a moderate success case in managing the pandemic [3]. The COVID-19 pandemic is straining health systems and disrupting the delivery of health care services, in particular, for older adults and people with chronic conditions, who are vulnerable to COVID-19 infection

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Discussion

Conclusion