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von Tottleben M, Grinyer K, Arfa A, Traore L, Verdoy D, Lim Choi Keung SN, Larranaga I, Jaulent MC, De Manuel Keenoy E, Lilja M, Beach M, Marguerie C, Yuksel M, Laleci Erturkmen GB, Klein GO, Lindman P, Mar J, Kalra D, Arvanitis TN. An Integrated Care Platform System (C3-Cloud) for Care Planning, Decision Support, and Empowerment of Patients With Multimorbidity: Protocol for a Technology Trial. JMIR Res Protoc 2022; 11:e21994. [PMID: 35830239 PMCID: PMC9330187 DOI: 10.2196/21994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/18/2020] [Accepted: 10/02/2021] [Indexed: 11/16/2022] Open
Abstract
Background There is an increasing need to organize the care around the patient and not the disease, while considering the complex realities of multiple physical and psychosocial conditions, and polypharmacy. Integrated patient-centered care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced information and communication technology solutions for semiautomated clinical decision support. Objective The Collaborative Care and Cure Cloud project (C3-Cloud) has developed 2 collaborative computer platforms for patients and members of the multidisciplinary team (MDT) and deployed these in 3 different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients with 2 or more chronic conditions (diabetes mellitus type 2, heart failure, kidney failure, depression), their informal caregivers, health care professionals, and, to some extent, health care systems. Methods This paper describes the protocol for conducting an evaluation of user experience, acceptability, and usefulness of the platforms. For this, 2 “testing and evaluation” phases have been defined, involving multiple qualitative methods (focus groups and surveys) and advanced impact modeling (predictive modeling and cost-benefit analysis). Patients and health care professionals were identified and recruited from 3 partnering regions in Spain, Sweden, and the United Kingdom via electronic health record screening. Results The technology trial in this 4-year funded project (2016-2020) concluded in April 2020. The pilot technology trial for evaluation phases 3 and 4 was launched in November 2019 and carried out until April 2020. Data collection for these phases is completed with promising results on platform acceptance and socioeconomic impact. We believe that the phased, iterative approach taken is useful as it involves relevant stakeholders at crucial stages in the platform development and allows for a sound user acceptance assessment of the final product. Conclusions Patients with multiple chronic conditions often experience shortcomings in the care they receive. It is hoped that personalized care plan platforms for patients and collaboration platforms for members of MDTs can help tackle the specific challenges of clinical guideline reconciliation for patients with multimorbidity and improve the management of polypharmacy. The initial evaluative phases have indicated promising results of platform usability. Results of phases 3 and 4 were methodologically useful, yet limited due to the COVID-19 pandemic. Trial Registration ClinicalTrials.gov NCT03834207; https://clinicaltrials.gov/ct2/show/NCT03834207 International Registered Report Identifier (IRRID) RR1-10.2196/21994
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Affiliation(s)
- Malte von Tottleben
- empirica Gesellschaft für Kommunikations- und Technologieforschung mbH, Bonn, Germany
| | - Katie Grinyer
- empirica Gesellschaft für Kommunikations- und Technologieforschung mbH, Bonn, Germany
| | - Ali Arfa
- empirica Gesellschaft für Kommunikations- und Technologieforschung mbH, Bonn, Germany
| | - Lamine Traore
- Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Inserm, Sorbonne Université, Université Paris 13, Paris, France
| | - Dolores Verdoy
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Sarah N Lim Choi Keung
- Institute of Digital Healthcare (IDH), Warwick Manufacturing Group, University of Warwick, Coventry, United Kingdom
| | - Igor Larranaga
- Kronikgune Institute for Health Services Research, Barakaldo, Spain.,Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Guipúzcoa, Spain
| | - Marie-Christine Jaulent
- Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Inserm, Sorbonne Université, Université Paris 13, Paris, France
| | | | - Mikael Lilja
- Unit of Research, Education, and Development Östersund, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Marie Beach
- South Warwickshire University NHS Foundation Trust, Warwick, United Kingdom
| | | | - Mustafa Yuksel
- Software Research Development and Consultancy Cooperation, SRDC A.S., Ankara, Turkey
| | | | - Gunnar O Klein
- School of Business (Informatics), Örebro University, Örebro, Sweden
| | | | - Javier Mar
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Guipúzcoa, Spain
| | | | | | - Theodoros N Arvanitis
- Institute of Digital Healthcare (IDH), Warwick Manufacturing Group, University of Warwick, Coventry, United Kingdom
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Karni L, Dalal K, Memedi M, Kalra D, Klein GO. Information and Communications Technology-Based Interventions Targeting Patient Empowerment: Framework Development. J Med Internet Res 2020; 22:e17459. [PMID: 32845245 PMCID: PMC7481871 DOI: 10.2196/17459] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/04/2020] [Accepted: 06/03/2020] [Indexed: 01/22/2023] Open
Abstract
Background Empowerment of patients is often an explicit goal of various information and communications technology (ICT) (electronic, digital) interventions where the patients themselves use ICT tools via the internet. Although several models of empowerment exist, a comprehensive and pragmatic framework is lacking for the development of such interventions. Objective This study proposes a framework for digital interventions aiming to empower patients that includes a methodology that links objectives, strategies, and evaluation. Methods This study is based on a literature review and iterated expert discussions including a focus group to formulate the proposed model. Our model is based on a review of various models of empowerment and models of technology intervention. Results Our framework includes the core characteristics of the empowerment concept (control, psychological coping, self-efficacy, understanding, legitimacy, and support) as well as a set of empowerment consequences: expressed patient perceptions, behavior, clinical outcomes, and health systems effects. The framework for designing interventions includes strategies to achieve empowerment goals using different ICT services. Finally, the intervention model can be used to define project evaluations where the aim is to demonstrate empowerment. The study also included example indicators and associated measurement instruments. Conclusions This framework, which includes definitions, can be useful for the design and evaluation of digital interventions targeting patient empowerment and assist in the development of methods to measure results in this dimension. Further evaluation in the form of interventional studies will be needed to assess the generalizability of the model.
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Affiliation(s)
- Liran Karni
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
| | - Koustuv Dalal
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden.,School of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Mevludin Memedi
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
| | - Dipak Kalra
- European Institute for Innovation through Health Data, Gent, Belgium
| | - Gunnar Oskar Klein
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
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