From chronic disease management to person-centered eHealth; a review on the necessity for blended care

Abstract

Background A growing need for structural changes in the organization of the health care system has emerged from the fast-growing number of people with chronic illnesses. eHealth supported self-management programs offer a way to change the traditional approach to person-centered care. Objective Inclusion and evaluation of the studies e-Vita and PORTALS, which focused on the necessary elements for implementation of eHealth supported self-management for Chronic Obstructive Pulmonary Disease (COPD) and Oral Anticoagulation Therapy (OAT) patients. Summary Based on this narrative review of the e-Vita COPD study and the PORTALS study, we conclude that eHealth supported self-management integrated into usual care can help patients with COPD and OAT to manage their disease better. We assume that blended care with total integration of eHealth and usual care will provide better quality of care in the long term. While eHealth-supported self-management was not superior to usual care for health status, the studies reported no negative effects, suggesting that eHealth is a safe option for delivery of self-management support and high quality disease management. Usage of the eHealth platforms is better under conditions of perfect integration into usual care and with personal assistance and coaching of patients. The usage is the highest for the patients with platforms that add high practical value to day to day life. The need to educate and coach patients in the use of web-based platforms and to educate healthcare professionals to take a different role, is of great importance. Furthermore, eHealth supported self-management programs need to be offered for a sufficient period to give patients the chance to change their behavior, and finally achieve a better health status. Implications for future research and clinical practice More studies are needed (preferably with larger sample groups, and including non-users) to gain more insight into the optimal combination of usual care and eHealth based self-management, the preferences and needs of various patients, the necessary education for healthcare professionals and patients, the best platform for patients that is easy to use, as well as the related costs.