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BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2020

Open Access 01-12-2020 | Care | Research article

Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece

Authors: Violeta Gaveikaite, Casandra Grundstrom, Stefan Winter, Helen Schonenberg, Minna Isomursu, Ioanna Chouvarda, Nicos Maglaveras

Published in: BMC Medical Informatics and Decision Making | Issue 1/2020

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Abstract

Background

Telehealth (TH) was introduced as a promising tool to support integrated care for the management of chronic obstructive pulmonary disease (COPD). It aims at improving self-management and providing remote support for continuous disease management. However, it is often not clear how TH-supported services fit into existing pathways for COPD management. The objective of this study is to uncover where TH can successfully contribute to providing care for COPD patients exemplified in a Greek care pathway. The secondary objective is to identify what conditions need to be considered for successful implementation of TH services.

Methods

Building on a single case study, we used a two-phase approach to identify areas in a Greek COPD care pathway where care services that are recommended in clinical guidelines are currently not implemented (challenges) and areas that are not explicitly recommended in the guidelines but that would benefit from TH services (opportunities). In phase I, we used the care delivery value chain framework to identify the divergence between the clinical guidelines and the actual practice captured by a survey with COPD healthcare professionals. In phase II, we conducted in-depth interviews with the same healthcare professionals based on the discovered divergences. The responses were analyzed with respect to identified opportunities for TH and care pathway challenges.

Results

Our results reveal insights in two areas. First, several areas with challenges were identified: patient education, self-management, medication adherence, physical activity, and comorbidity management. TH opportunities were perceived as offering better bi-directional communication and a tool for reassuring patients. Second, considering the identified challenges and opportunities together with other case context details a set of conditions was extracted that should be fulfilled to implement TH successfully.

Conclusions

The results of this case study provide detailed insights into a care pathway for COPD in Greece. Addressing the identified challenges and opportunities in this pathway is crucial for adopting and implementing service innovations. Therefore, this study contributes to a better understanding of requirements for the successful implementation of integrated TH services in the field of COPD management. Consequently, it may encourage healthcare professionals to implement TH-supported services as part of routine COPD management.
Appendix
Available only for authorised users
Footnotes
1
For ease of referencing, we will refer to the case study site as ‘Asclepius’ for anonymization purposes, and to prevent revealing the identity of the hospital and/or staff.
 
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Metadata
Title
Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece
Authors
Violeta Gaveikaite
Casandra Grundstrom
Stefan Winter
Helen Schonenberg
Minna Isomursu
Ioanna Chouvarda
Nicos Maglaveras
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2020
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-020-01221-y

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