欧洲综合医疗的数字健康转型：17个综合医疗项目的总体分析
Digital Health Transformation of Integrated Care in Europe: Overarching Analysis of 17 Integrated Care Programs.
作者信息
Baltaxe Erik, Czypionka Thomas, Kraus Markus, Reiss Miriam, Askildsen Jan Erik, Grenkovic Renata, Lindén Tord Skogedal, Pitter János György, Rutten-van Molken Maureen, Solans Oscar, Stokes Jonathan, Struckmann Verena, Roca Josep, Cano Isaac
机构信息
Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.
Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain.
出版信息
J Med Internet Res. 2019 Sep 26;21(9):e14956. doi: 10.2196/14956.
BACKGROUND
Digital health tools comprise a wide range of technologies to support health processes. The potential of these technologies to effectively support health care transformation is widely accepted. However, wide scale implementation is uneven among countries and regions. Identification of common factors facilitating and hampering the implementation process may be useful for future policy recommendations.
OBJECTIVE
The aim of this study was to analyze the implementation of digital health tools to support health care and social care services, as well as to facilitate the longitudinal assessment of these services, in 17 selected integrated chronic care (ICC) programs from 8 European countries.
METHODS
A program analysis based on thick descriptions-including document examinations and semistructured interviews with relevant stakeholders-of ICC programs in Austria, Croatia, Germany, Hungary, the Netherlands, Norway, Spain, and the United Kingdom was performed. A total of 233 stakeholders (ie, professionals, providers, patients, carers, and policymakers) were interviewed from November 2014 to September 2016. The overarching analysis focused on the use of digital health tools and program assessment strategies.
RESULTS
Supporting digital health tools are implemented in all countries, but different levels of maturity were observed among the programs. Only few ICC programs have well-established strategies for a comprehensive longitudinal assessment. There is a strong relationship between maturity of digital health and proper evaluation strategies of integrated care.
CONCLUSIONS
Notwithstanding the heterogeneity of the results across countries, most programs aim to evolve toward a digital transformation of integrated care, including implementation of comprehensive assessment strategies. It is widely accepted that the evolution of digital health tools alongside clear policies toward their adoption will facilitate regional uptake and scale-up of services with embedded digital health tools.
背景
数字健康工具包含广泛的技术以支持健康流程。这些技术有效支持医疗保健转型的潜力已得到广泛认可。然而，各国和各地区的大规模实施情况并不均衡。识别促进和阻碍实施过程的共同因素可能有助于未来的政策建议。
目的
本研究旨在分析8个欧洲国家17个选定的综合慢性病护理（ICC）项目中数字健康工具的实施情况，以支持医疗保健和社会护理服务，并促进对这些服务的纵向评估。
方法
对奥地利、克罗地亚、德国、匈牙利、荷兰、挪威、西班牙和英国的ICC项目进行基于详细描述的项目分析，包括文件审查和与相关利益相关者的半结构化访谈。2014年11月至2016年9月期间，共采访了233名利益相关者（即专业人员、提供者、患者、护理人员和政策制定者）。总体分析重点关注数字健康工具的使用和项目评估策略。
结果
所有国家都在实施支持性数字健康工具，但各项目的成熟度水平不同。只有少数ICC项目拥有完善的全面纵向评估策略。数字健康的成熟度与综合护理的适当评估策略之间存在密切关系。
结论
尽管各国结果存在异质性，但大多数项目旨在朝着综合护理的数字化转型发展，包括实施全面评估策略。人们普遍认为，数字健康工具的发展以及明确的采用政策将促进采用嵌入式数字健康工具的服务在区域内的采用和推广。
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