eHealth education should be integrated into vocational training and continuous professional development programmes. In this opinion article, we aim to support organisers of Continuing Professional Development (CPD) and teachers delivering medical vocational training by providing recommendations for eHealth education. First, we describe what is required to help primary care professionals and trainees learn about eHealth. Second, we elaborate on how eHealth education might be provided
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Background: This study investigates patients’ use of eHealth services, their awareness of the availability of these services, and their intention to use them in primary care. It also examines patient characteristics and factors that influence the use of these services. Methods: A cross-sectional design using questionnaires was conducted. Based on the unified theory of acceptance and use of technology (UTAUT), the participants rated the two most common services. Descriptive analyses and linear correlation analyses were performed. A simple linear regression was conducted to identify factors influencing the participants’ intention to use eHealth services. Results: In total, 1203 participants with an average age of 43.7 years were surveyed. The participants’ usage rates varied, with the lowest at 2.4%, for measuring vital signs, and the highest at 47.4%, for booking appointments. The intentions to use the services ranged from 22.5%, for video consultations, to 46.6%, for prescription refill requests. Approximately 20% of the respondents were unaware of each service’s availability. Positive associations were found between all the constructs and the intention to use online services, with a younger age being the most significant factor. Conclusions: The use of and intention to use eHealth services varied greatly. The participants were often unaware of the availability of these services. Promoting the availability and benefits of eHealth services could enhance patient engagement in primary care settings.
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Background: The strain on health care services is increasing due to an ageing population and the increasing prevalence of chronic health conditions. eHealth could contribute to optimise effective and efficient care to older adults with one or more chronic health conditions in the general practice. Aim: The aim of this study was to identify the needs, barriers and facilitators amongst community-dwelling older adults (60þ) suffering from one or more chronic health conditions, in using online eHealth applications to support general practice services. Methods: A qualitative study, using semi-structured followed by think-aloud interviews, was conducted in the Netherlands. The semi-structured interviews, supported by an interview guide were conducted and analysed thematically. The think-aloud method was used to collect data about the cognitive process while the participant was completing a task within online eHealth applications. Verbal analysis according to the Chi approach was conducted to analyse the think-aloud interviews. Findings: A total of n = 19 older adults with a mean age of 73 years participated. The ability to have immediate contact with the GP on important health issues was identified as an important need. Identified barriers were non-familiarity with the online eHealth applications and a mismatch of user health needs. The low computer experience resulted in non-familiarity with the online eHealth applications. Faltering applications resulted in participants refusing to participate in the use of online eHealth applications. Convenience, efficiency and the instant availability of eHealth via applications were identified as important facilitators. Conclusion: To improve the use and acceptability of eHealth applications amongst older adults in the general practice, the applications should be tailored to meet individual needs. More attention should be given to improving the user-friendliness of these applications and to the promotion of the benefits such as facilitating older adults independent living for longer.
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Abstract: This case study examines the use of an eHealth application for improving preoperative rehabilitation (prehabilitation). We have analysed healthcare professionals' motivators and drivers for adopting eHealth for a surgical procedure at academic medical facilities. The research focused on when and why healthcare professionals are inclined to adopt eHealth applications in their way of working? For this qualitative study, we selected 12 professionals involved in all levels of the organisation and stages of the medical process and conducted semi-structured interviews. Kotter’s transformational change model and the Technology Acceptance Model were used as analytical frameworks for the identification of the motivation of eHealth adoption. The findings suggest that contrary to Kotter’s change model, which argues that adoption of change is based on perceptions and feelings, the healthcare drivers are rational when it comes to deciding whether or not to adopt eHealth apps. This study further elaborates the observation made by the Dutch expertise centre on eHealth, Nictiz, that when the value of an eHealth pplication is clear for a stakeholder, the adoption process accelerates. Analysis of the motivations and drivers of the healthcare professionals show a strong relationship with an evidence-based grounding of usefulness and the responsibility these professionals have towards their patients. We found that healthcare professionals respond to the primary goal of improving healthcare. This is true if the eHealth application will innovate their work, but mainly when the application will improve the patient care they are responsible for. When eHealth applications are implemented, rational facts need to be collected in a study before deployment of eHealth applications on how these applications will improve the patient's health or wellbeing throughout their so-called medical journey for their treatment. Furthermore, the preference to learn about new eHealth applications from someone who speaks from authority through expertise on the subject matter, suggests adoption by healthcare professionals may be accelerated through peers. The result of this study may provide healthcare management with a different approach to their eHealth strategy. Future research is needed to validate the findings in different medical organisational settings such as regional healthcare facilities or for-profit centers which do not necessarily have an innovation focus but are driven by other strategic drivers.
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Alongside the growing number of older persons, the prevalence of chronic diseases is increasing, leading to higher pressure on health care services. eHealth is considered a solution for better and more efficient health care. However, not every patient is able to use eHealth, for several reasons. This study aims to provide an overview of: (1) sociodemographic factors that influence the use of eHealth; and (2) suggest directions for interventions that will improve the use of eHealth in patients with chronic disease. A structured literature review of PubMed, ScienceDirect, Association for Computing Machinery Digital Library (ACMDL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted using four sets of keywords: “chronic disease”, “eHealth”, “factors”, and “suggested interventions”. Qualitative, quantitative, and mixed-method studies were included. Four researchers each assessed quality and extracted data. Twenty-two out of 1639 articles were included. Higher age and lower income, lower education, living alone, and living in rural areas were found to be associated with lower eHealth use. Ethnicity revealed mixed outcomes. Suggested solutions were personalized support, social support, use of different types of Internet devices to deliver eHealth, and involvement of patients in the development of eHealth interventions. It is concluded that eHealth is least used by persons who need it most. Tailored delivery of eHealth is recommended
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Integrated approach aims at bridging the gap between theory and practice in designing persuasive eHealth applications. Developed from a didactic and educational perspective and is being implemented in our master program. It enables our master students to design user-centered persuasive eHealth applications. Inspiring educators on how to teach design of persuasive eHealth applications and support development of best practices in this area.
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Abstract Background: Integrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients’ involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings. Aim: The primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients. Methods: We evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the intervention. Results: Of 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually used the eHealth platform (n = 123). The decrease of CCQ-symptoms was 0.20% before the intervention and 0.27% after the intervention; this difference in slopes was statistically significant (P = 0.027). The decrease of CCQ-mental was 0.97% before the intervention and after the intervention there was an increase of 0.017%; this difference was statistically significant (P = 0.01). No significant difference was found in the slopes of CCQ (P = 0.12) and CCQ-function (P = 0.11) before and after the intervention. Conclusion: The e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management. Trial registration: Our study is registered in the Dutch Trial Register (national registration of clinical trails, mandatory for publication) with number NTR4098 and can be found at http://www.trialregister.nl/trial/3936.
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Het boek ‘Create Health Ways of Working: Insights from ten eHealth innovation research projects’ presenteert inzichten uit het meta-onderzoeksproject ‘Create & Health Innovation WAys of Working Analysis’, ook wel CHIWAWA genoemd. Binnen dit meta-onderzoeksproject inventariseerden onderzoekers van de Hogeschool Utrecht (Lectoraat Onderzoekend Vermogen en Lectoraat Co-design) het gebruik van creatieve manieren van werken bij innovatieprocessen in de zorg, waarvoor zij tien onderzoeksprojecten van Nederlandse kennisinstellingen volgende in de periode 2018 – 2022. Deze tien onderzoeksprojecten en het meta-onderzoek waren onderdeel van het ZonMw-programma Create Health. Het boek presenteert case-portretten van de tien onderzoeksprojecten naar eHealth innovatie die zich concentreerden rondom de thema’s dementie, eenzaamheid en overgewicht. Vervolgens geeft het boek verdieping met betrekking tot de creatieve manieren van werken in de tien Create Health-onderzoeksprojecten, begrip van relationele processen bij het creëren van kennisuitwisseling en zicht op de impact die een dergelijke samenwerking heeft op de zorg- en welzijnssector en op de creatieve industrie. Het boek bevat aanbevelingen voor toekomstige onderzoeksconsortia, financiers en de praktijk (creatieve industrie, zorgsector en doelgroep) en sluit af met de beschrijving van een tool die gebaseerd is op het Research Pathway Model, dat als instrument gebruikt kan worden om het gesprek tussen stakeholders van innovatieprocessen in de zorg te ondersteunen.
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An integrated, systematic and practical, scientifically based methodology to design effective persuasive eHealth applications is being proposed. It is developed from a didactic and educational perspective
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Abstract Background Clients with severe mental illness (SMI) have overall poor physical health. SMI reduces life expectancy by 5–17 years, primarily due to physical comorbidity linked to cardiometabolic risks that are mainly driven by unhealthy lifestyle behaviours. To improve physical health in clients with SMI, key elements are systematic somatic screening and lifestyle promotion. The nurse-led GILL eHealth was developed for somatic screening and the imple‑ mentation of lifestyle activities in clients with SMI. Aims of this study are to evaluate the efectiveness of the GILL eHealth intervention in clients with SMI compared to usual care, and to evaluate the implementation process, and the experiences of clients and healthcare providers with GILL eHealth. Methods The GILL study encompasses a cluster-randomised controlled trial in approximately 20 mental health care facilities in the Netherlands. The randomisation takes place at the team level, assigning clients to the eHealth inter‑ vention or the usual care group. The GILL eHealth intervention consists of two complementary modules for somatic screening and lifestyle promotion, resulting in personalised somatic treatment and lifestyle plans. Trained mental health nurses and nurse practitioners will implement the intervention within the multidisciplinary treatment context, and will guide and support the participants in promoting their physical health, including cardiometabolic risk management. Usual care includes treatment as currently delivered, with national guidelines as frame of reference. We aim to include 258 clients with SMI and a BMI of 27 or higher. Primary outcome is the metabolic syndrome severity score. Secondary outcomes are physical health measurements and participants’ reports on physical activity, perceived lifestyle behaviours, quality of life, recovery, psychosocial functioning, and health-related self-efcacy. Measurements will be completed at baseline and at 6 and 12 months. A qualitative process evaluation will be conducted alongside, to evaluate the process of implementation and the experiences of clients and healthcare professionals with GILL eHealth. Discussion The GILL eHealth intervention is expected to be more efective than usual care in improving physical health and lifestyle behaviours among clients with SMI. It will also provide important information on implementation of GILL eHealth in mental health care. If proven efective, GILL eHealth ofers a clinically useful tool to improve physical health and lifestyle behaviours.
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