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Dagens #fsvoversigt:
The chronic care model and technological research and innovation: a scoping
review at the crossroads.
J Med Internet Res. 2015;17(2):e25
Authors: Gammon D, Berntsen GK, Koricho AT, Sygna K, Ruland C
Abstract
BACKGROUND: Information and communication technologies (ICT) are key to
optimizing the outcomes of the Chronic Care Model (CCM), currently acknowledged
as the best synthesis of available evidence for chronic illness prevention and
management. At the same time, CCM can offer a needed framework for increasing
the relevance and feasibility of ICT innovation and research in health care.
Little is known about how and to what extent CCM and ICT research inform each
other to leverage mutual strengths. The current study examines: What
characterizes work being done at the crossroads of CCM and ICT research and
innovation?
OBJECTIVE: Our aim is identify the gaps and potential that lie between the
research domains CCM and ICT, thus enabling more substantive questions and
opportunities for accelerating improvements in ICT-supported chronic care.
METHODS: Using a scoping study approach, we developed a search strategy applied
to medical and technical databases resulting in 1054 titles and abstracts that
address CCM and ICT. After iteratively adapting our inclusion/exclusion
criteria to balance between breadth and feasibility, 26 publications from 20
studies were found to fulfill our criteria. Following initial coding of each
article according to predefined categories (eg, type of article, CCM component,
ICT, health issue), a 1st level analysis was conducted resulting in a broad
range of categories. These were gradually reduced by constantly comparing them
for underlying commonalities and discrepancies.
RESULTS: None of the studies included were from technical databases and
interventions relied mostly on "old-fashioned" technologies. Technologies
supporting "productive interactions" were often one-way (provider to patient),
and it was sometimes difficult to decipher how CCM was guiding intervention
design. In particular, the major focus on ICT to support providers did not
appear unique to the challenges of chronic care. Challenges in facilitating CCM
components through ICT included poorly designed user interfaces, digital divide
issues, and lack of integration with existing infrastructure.
CONCLUSIONS: The CCM is a highly influential guide for health care development,
which recognizes the need for alignment of system tools such as ICT. Yet, there
seem to be alarmingly few touch points between the subject fields of "health
service development" and "ICT-innovation". Bridging these gaps needs explicit
and urgent attention as the synergies between these domains have enormous
potential. Policy makers and funding agencies need to facilitate the joining of
forces between high-tech innovative expertise and experts in the chronic care
system redesign that is required for tackling the current epidemic of long-term
multiple conditions.
PMID: 25677200 [PubMed - indexed for MEDLINE]
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
(http://www.ncbi.nlm.nih.gov/About/disclaimer.html).
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Se abstractet i PubMed: http://evidens.link/1KFYT1x
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