Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece
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 ho...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12911-020-01221-y |
| _version_ | 1818976341909831680 |
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| author | Violeta Gaveikaite Casandra Grundstrom Stefan Winter Helen Schonenberg Minna Isomursu Ioanna Chouvarda Nicos Maglaveras |
| author_facet | Violeta Gaveikaite Casandra Grundstrom Stefan Winter Helen Schonenberg Minna Isomursu Ioanna Chouvarda Nicos Maglaveras |
| author_sort | Violeta Gaveikaite |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-20T16:10:19Z |
| format | Article |
| id | doaj.art-874dbb8f99644e4d9752f44df050222e |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-12-20T16:10:19Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-874dbb8f99644e4d9752f44df050222e2022-12-21T19:34:00ZengBMCBMC Medical Informatics and Decision Making1472-69472020-09-0120111210.1186/s12911-020-01221-yChallenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in GreeceVioleta Gaveikaite0Casandra Grundstrom1Stefan Winter2Helen Schonenberg3Minna Isomursu4Ioanna Chouvarda5Nicos Maglaveras6Laboratory of Computer Science, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Faculty of Health Sciences, Aristotle University of ThessalonikiM3S, Faculty of Information Technology and Electrical Engineering, University of OuluDepartment of Collaborative Care Solutions, Philips ResearchDepartment of Collaborative Care Solutions, Philips ResearchM3S, Faculty of Information Technology and Electrical Engineering, University of OuluLaboratory of Computer Science, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Faculty of Health Sciences, Aristotle University of ThessalonikiLaboratory of Computer Science, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Faculty of Health Sciences, Aristotle University of ThessalonikiAbstract 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.http://link.springer.com/article/10.1186/s12911-020-01221-yTelehealthCOPDChronic obstructive pulmonary diseaseIntegrated careCase studyOpportunities |
| spellingShingle | Violeta Gaveikaite Casandra Grundstrom Stefan Winter Helen Schonenberg Minna Isomursu Ioanna Chouvarda Nicos Maglaveras Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece BMC Medical Informatics and Decision Making Telehealth COPD Chronic obstructive pulmonary disease Integrated care Case study Opportunities |
| title | Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece |
| title_full | Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece |
| title_fullStr | Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece |
| title_full_unstemmed | Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece |
| title_short | Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece |
| title_sort | challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease a qualitative case study in greece |
| topic | Telehealth COPD Chronic obstructive pulmonary disease Integrated care Case study Opportunities |
| url | http://link.springer.com/article/10.1186/s12911-020-01221-y |
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