Gandarillas Miguel Ángel, Sánchez-de-Madariaga Ricardo, Muñoz-Carrero Adolfo, Goswami Nandu
Department of Social, Work and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.
Telemedicine and Digital Health Research Unit, Instituto de Salud Carlos III, Madrid, Spain.
Clin Interv Aging. 2025 Sep 2;20:1455-1470. doi: 10.2147/CIA.S525246. eCollection 2025.
The development of home-based clinical interventions and healthcare supported by digital tools has rapidly advanced in recent years, promising improvements in preventive and personalized treatment, especially for aging chronic patients. However, many systems are launched without feedback from healthcare experts, essential for understanding their strengths, limitations, and areas for improvement. This study had two objectives: first, to gather expert opinions on the qualities and limitations of current home-centred healthcare trends for aging patients; second, as a case study, to obtain feedback on a novel system, (TI-Health), integrating these trends. TI-Health uses real-time data to combine bio-psycho-social information through big data and machine learning, enabling health status prediction, diagnosis, prevention, and treatment.
A Delphi group of 60 experts from 9 countries, all with experience using digital health systems, was surveyed. A questionnaire was administered to the group focused on the limitations and qualities of current home-based digital healthcare trends. In addition, the Delphi group provided feedback on the TI-Health system.
A majority of experts believed that personalized healthcare delivered in the patient's home will shape the future of healthcare services. The Delphi group identified key qualities of these trends: improved service integration, enhanced patient comfort, cost reduction, and a deeper understanding of the patient's context. They also highlighted challenges, such as barriers to inter-agency collaboration and data sharing, resistance to change among healthcare professionals, and the need for strong leadership to drive the adoption of new systems. Based on the insights from the Delphi group, this work presents a refined conceptualization of the TI-Health system.
Designing home-based clinical systems such as should prioritize effective inter-agency coordination, ensuring data protection and fostering collaborative leadership throughout the implementation process. These factors are crucial to the successful adoption and utilization of new home-based digital health solutions.
近年来，由数字工具支持的家庭临床干预和医疗保健发展迅速，有望改善预防性和个性化治疗，特别是对于老年慢性病患者。然而，许多系统在没有医疗保健专家反馈的情况下就推出了，而专家反馈对于了解系统的优势、局限性和改进领域至关重要。本研究有两个目标：第一，收集专家对当前以家庭为中心的老年患者医疗保健趋势的质量和局限性的意见；第二，作为一个案例研究，获取关于整合这些趋势的新型系统（TI-Health）的反馈。TI-Health利用实时数据，通过大数据和机器学习来整合生物心理社会信息，实现健康状况预测、诊断、预防和治疗。
对来自9个国家的60名专家组成的德尔菲小组进行了调查，所有专家都有使用数字健康系统的经验。向该小组发放了一份问卷，重点关注当前家庭数字医疗保健趋势的局限性和质量。此外，德尔菲小组还对TI-Health系统提供了反馈。
大多数专家认为，在患者家中提供的个性化医疗保健将塑造未来医疗服务的格局。德尔菲小组确定了这些趋势的关键质量：改善服务整合、提高患者舒适度、降低成本以及更深入地了解患者情况。他们还强调了挑战，如机构间协作和数据共享的障碍、医疗保健专业人员对变革持抵触态度，以及需要强有力的领导来推动新系统的采用。基于德尔菲小组的见解，本研究提出了TI-Health系统的优化概念。
设计如TI-Health这样的家庭临床系统时，应优先考虑有效的机构间协调，确保数据保护，并在整个实施过程中培养协作式领导能力。这些因素对于新的家庭数字健康解决方案的成功采用和利用至关重要。
