Promoting primary healthcare services resilience with chronic disease management digitalization: a foresight study in the Lisbon health region

Abstract

Abstract Background Due to the pressure on health systems, the COVID-19 Pandemic forced administrators to rapidly harness and integrate existing technology to manage access of patients with chronic diseases to Primary Health Care (PHC) in Portugal. Studies show that one of the most important areas for improvement is the sustainability of artefacts after the implementation phase, which depends on the successful implementation of digital transformation. As such, this study aims to assess the impact and influence of digitalization of PHC to settle a set of actions to be taken so that implementation is carried out more effectively and to support evidence-based policy-making in a PHC Unit located in the peripheral area of Lisbon. Methods This study followed a collaborative foresight approach using a scenario development methodology proposed by Lapão and Thore, divided into three stages: understanding the context, developing scenarios, and their analysis. These steps were achieved by conducting focus groups using the thematic brainstorming approach to analyse strategic and operational scenarios within ten years (between 2022 and 2032). Results Considering the influence of digitalization of PHC in the next ten years, three relevant and plausible scenarios were developed: ‘Digital PHC and active patients’, ‘NHS transition’ and ‘Climate exigency’. Combining innovation skills to establish digital services with improved governance policies has shown significant benefits toward the goals of more patient-centred care. Conclusions The collaborative reflection process throughout the study made the different stakeholders identify and understand the impact of the essential measures to be taken in different scenarios, allowing the digitalization of PHCs to be implemented more effectively, enabling the sustainability of the National Health Service in the Lisbon region, which has only been discussed so far at a limited and theoretical level.