Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative ca
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RESEARCH ARTICLE
(2020) 20:216
Open Access
Challenges and opportunities for telehealth in the management of chronic obstructive pulmonary disease: a qualitative case study in Greece Violeta Gaveikaite 1,2* , Casandra Grundstrom3, Stefan Winter4, Helen Schonenberg2, Minna Isomursu3, Ioanna Chouvarda1 and Nicos Maglaveras1,5
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. (Continued on next page)
* Correspondence: [email protected] 1 Laboratory of Computer Science, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece 2 Department of Collaborative Care Solutions, Philips Research, High Tech Campus 34, 5656AE Eindhoven, The Netherlands Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons lic
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