University of Oulu

Gaveikaite, V., Grundstrom, C., Winter, S. et al. Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece. BMC Med Inform Decis Mak 20, 216 (2020). https://doi.org/10.1186/s12911-020-01221-y

Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease : a qualitative case study in Greece

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Author: Gaveikaite, Violeta1,2; Grundstrom, Casandra3; Winter, Stefan4;
Organizations: 1Laboratory of Computer Science, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
2Department of Collaborative Care Solutions, Philips Research, High Tech Campus 34, 5656AE Eindhoven, The Netherlands
3M3S, Faculty of Information Technology and Electrical Engineering, University of Oulu, Pentii Kaiteran katu 1, 8000, FI-90014 Oulu, Finland
4Department of Collaborative Care Solutions, Philips Research, Pauwelsstraße, 17 52074 Aachen, Germany
5Department of IEMS,McCormick School of Engineering, Northwestern University, Evanston, IL, USA
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2020111890966
Language: English
Published: Springer Nature, 2020
Publish Date: 2020-11-18
Description:

Abstract

Background: Telehealth (TH) was introduced as a promising tool to support integrated care for the management of chronic obstructive pulmonary disease (COPD). It aims at improving self-management and providing remote support for continuous disease management. However, it is often not clear how TH-supported services fit into existing pathways for COPD management. The objective of this study is to uncover where TH can successfully contribute to providing care for COPD patients exemplified in a Greek care pathway. The secondary objective is to identify what conditions need to be considered for successful implementation of TH services.

Methods: Building on a single case study, we used a two-phase approach to identify areas in a Greek COPD care pathway where care services that are recommended in clinical guidelines are currently not implemented (challenges) and areas that are not explicitly recommended in the guidelines but that would benefit from TH services (opportunities). In phase I, we used the care delivery value chain framework to identify the divergence between the clinical guidelines and the actual practice captured by a survey with COPD healthcare professionals. In phase II, we conducted in-depth interviews with the same healthcare professionals based on the discovered divergences. The responses were analyzed with respect to identified opportunities for TH and care pathway challenges.

Results: Our results reveal insights in two areas. First, several areas with challenges were identified: patient education, self-management, medication adherence, physical activity, and comorbidity management. TH opportunities were perceived as offering better bi-directional communication and a tool for reassuring patients. Second, considering the identified challenges and opportunities together with other case context details a set of conditions was extracted that should be fulfilled to implement TH successfully.

Conclusions: The results of this case study provide detailed insights into a care pathway for COPD in Greece. Addressing the identified challenges and opportunities in this pathway is crucial for adopting and implementing service innovations. Therefore, this study contributes to a better understanding of requirements for the successful implementation of integrated TH services in the field of COPD management. Consequently, it may encourage healthcare professionals to implement TH-supported services as part of routine COPD management.

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Series: BMC medical informatics and decision making
ISSN: 1472-6947
ISSN-E: 1472-6947
ISSN-L: 1472-6947
Volume: 20
Issue: 1
Article number: 216
DOI: 10.1186/s12911-020-01221-y
OADOI: https://oadoi.org/10.1186/s12911-020-01221-y
Type of Publication: A1 Journal article – refereed
Field of Science: 113 Computer and information sciences
3121 General medicine, internal medicine and other clinical medicine
Subjects:
Funding: Authors VG and CG are funded from the European Union’s Horizon 2020 research and innovation programme - Marie Sklodowska-Curie Actions Grant Agreement No. 676201 - CHESS - Connected Health Early Stage Researcher Support System. Funding body had no influence on the design of the study, analysis of the data, the interpretation of the findings or the content of this manuscript.
Copyright information: © The Authors 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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