Synergy of patients and health professional in successful implementation of digital health tools

Introduction: The Swedish governmental vision of e-Health 2025 aims to provide patients with increased access to and influence over their health situation, promote equity and to support healthcare professionals in their work. As part of the digitalization, ePATH electronic Patient Activation support in Treatment at Home was developed. It is a multifaceted self-management intervention providing the patient access to tailored comprehensive information about diagnosis and treatment, their standardized care plan, list of medications, a tailored set of self-care activities and possibility to communicate healthcare contacts. ePATH is informed by Self-Determination Theory SDT, a general theory of motivation, where basic psychological needs are emphasized. Integrating motivational theory in ePATH, patients’ adherence and engagement could increase. Promoting autonomy, competence and relatedness have the possibility to foster motivation and engagement in self-care activities. However, the introduction of digital tools requires changed work processes and challenges the professionals’ role. Implementation of digital tools often fails, as they are not embedded and integrated into everyday practice, and are considered to hinder rather than support the professionals’ work. We aim is to study how the staffs´ digital readiness is related to the implementation of ePATH as a supportive tool for patients´ self-management in primary health care. 

Theory/Methods: Taking a sociocultural approach to digital literacy, professionals’ perceptions of their own capabilities to support patient´s self-management by use of ePATH will be analyzed. Digital literacy concerns the ability to act on the basis of digital tools, symbols, visual representations and external memory systems EMS. Data will be collected through group interviews, followed by direct observations and shadowing i.e., following a healthcare professional in their work. Data collection will be followed by periods of transcription and analysis, to subsequently inform the forthcoming observations and interviews.

Results: The project is expected to increase knowledge of how educational, informational and practical needs of the care professionals tasked with implementation of digital practices are met, and to describe how the implementation of ePATH affects efficiency and safety of professionals’ practice and views of their work and workplace.

Discussion/Conclusion: The challenges of Vision e-health 2025 incorporate motivated and engaged patients as well as health professionals. Effective self-management requires communication with, and support of the health professionals, through regular assessment of the patients’ health status and by providing encouragement to perform healthy behaviors, to translate knowledge into practice or social support for initiation and maintenance of the desired behavior. In a digital context, this implies new functions for health professionals on how to interact and meet the needs of the patients.

Lessons learned: Learning from draw-backs of previously developed digital health tools, we have involved health professionals and patients in the development process and emphasized the importance of motivation in getting patients to perform self-care. We learned that customized work processes and motivated professionals also is a prerequisite for a sustainable introduction of digital patient support.

Limitations: We report on baseline data from an ongoing study. 

Suggestions for future research:  More knowledge about what increased digitalization mean for the healthcare professions ‘role is needed.