Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.
J Med Internet Res. 2023 Apr 19;25:e44035. doi: 10.2196/44035.
Information and communications technologies (ICTs) are recognized as critical enablers of integrated primary care to support patients with multiple chronic conditions. Although ICT-enabled integrated primary care holds promise in supporting patients with complex care needs through team-based and continued care, critical implementation factors regarding what ICTs are available and how they enable this model are yet to be mapped in the literature.
This scoping review addressed the current knowledge gap by answering the following research question: What ICTs are used in delivering integrated primary care to patients with complex care needs?
The Arksey and O'Malley method enhanced by the work by Levac et al was used to guide this scoping review. In total, 4 electronic medical databases were accessed-MEDLINE, Embase, CINAHL, and PsycINFO-collecting studies published between January 2000 and December 2021. Identified peer-reviewed articles were screened. Relevant studies were charted, collated, and analyzed using the Rainbow Model of Integrated Care and the eHealth Enhanced Chronic Care Model.
A total of 52,216 articles were identified, of which 31 (0.06%) met the review's eligibility criteria. In the current literature, ICTs are used to serve the following functions in the integrated primary care setting: information sharing, self-management support, clinical decision-making, and remote service delivery. Integration efforts are supported by ICTs by promoting teamwork and coordinating clinical services across teams and organizations. Patient, provider, organizational, and technological implementation factors are considered important for ICT-based interventions in the integrated primary care setting.
ICTs play a critical role in enabling clinical and professional integration in the primary care setting to meet the health system-related needs of patients with complex care needs. Future research is needed to explore how to integrate technologies at an organizational and system level to create a health system that is well prepared to optimize technologies to support patients with complex care needs.
信息和通信技术(ICTs)被认为是整合初级保健的关键推动因素,可用于支持患有多种慢性病的患者。虽然基于 ICT 的整合初级保健有望通过团队合作和持续护理来满足具有复杂护理需求的患者,但关于现有的 ICT 以及它们如何支持这种模式的关键实施因素在文献中尚未得到映射。
本范围综述通过回答以下研究问题来解决当前的知识空白:用于为具有复杂护理需求的患者提供整合初级保健的 ICT 有哪些?
使用阿特金森和奥马利方法,并借鉴列瓦克等人的工作,指导本范围综述。总共访问了 4 个电子医学数据库-MEDLINE、Embase、CINAHL 和 PsycINFO-收集 2000 年 1 月至 2021 年 12 月期间发表的同行评审文章。筛选出相关的研究文章,并使用综合保健彩虹模型和电子健康增强的慢性病护理模型对其进行图表、整理和分析。
共确定了 52,216 篇文章,其中 31 篇(0.06%)符合审查的资格标准。在当前文献中,ICT 用于在整合初级保健环境中执行以下功能:信息共享、自我管理支持、临床决策和远程服务交付。通过促进团队合作和协调跨团队和组织的临床服务,ICT 支持整合工作。患者、提供者、组织和技术实施因素被认为是整合初级保健环境中基于 ICT 的干预措施的重要因素。
ICT 在实现初级保健环境中的临床和专业整合方面发挥着关键作用,以满足具有复杂护理需求的患者的卫生系统相关需求。需要进一步研究如何在组织和系统层面整合技术,以创建一个准备充分的卫生系统,优化技术以支持具有复杂护理需求的患者。