eHealth for people with multimorbidity: Results from the ICARE4EU project and insights from the "10 e's" by Gunther Eysenbach

PLoS One. 2018 Nov 14;13(11):e0207292. doi: 10.1371/journal.pone.0207292. eCollection 2018.

Abstract

Background: People with multimorbidity, especially older people, have complex health and social needs, and require an integrated care approach. In this respect, eHealth could be of support. This paper aims to describe the implementation of eHealth technologies in integrated care programs for people with multimorbidity in Europe, and to analyse related benefits and barriers according to outcomes from ICARE4EU study and within the more general conceptual framework of the "10 e's" in eHealth by Gunther Eysenbach.

Methods: In 2014, ICARE4EU project identified 101 integrated care programs in 24 European countries. Expert organizations and managers of the programs completed an on-line questionnaire addressing several aspects including the adoption of eHealth. Findings from this questionnaire were analyzed, by linking in particular benefits and barriers of eHealth with the "10 e's" by Eysenbach (Efficiency, Enhancing, Evidence-based, Empowerment, Encouragement, Education, Enabling, Extending, Ethics, and Equity).

Results: Out of 101 programs, 85 adopted eHealth tools, of which 42 focused explicitly on older people. eHealth could improve care integration/management, quality of care/life and cost-efficiency, whereas inadequate funding represents a major barrier. The "10 e's" by Eysenbach seem to show contact points with ICARE4EU findings, in particular when referring to positive aspects of eHealth such as Efficiency and Enhancing quality of care/life, although Empowerment/Education of patients, care Equity and Ethics issues seem crucial in this respect. Encouragement of a new relationship patient-health professional, and Enabling standardized exchange of electronic information, represent further aspects impacting integration/management of care.

Conclusions: Aspects of eHealth, which emerged as benefits and barriers impacting integration/management of care, as well as cost-efficiency and quality of care/life, can be identified on the basis of both ICARE4EU findings and the "10 e's" in eHealth by Eysenbach. They could represent objectives of new policies for supporting the deployment of eHealth technologies within integrated care across Europe.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cost-Benefit Analysis
  • Europe
  • Humans
  • Multimorbidity*
  • Quality of Health Care
  • Quality of Life
  • Surveys and Questionnaires
  • Telemedicine / economics
  • Telemedicine / methods*

Grants and funding

This publication arises from the project Innovating care for people with multiple chronic conditions in Europe (ICARE4EU) Project, which has received funding from the European Union, in the framework of the Health Programme 2008-2013 of the European Union, (CHAFEA, The Consumers, Health, Agriculture and Food Executive Agency, http://ec.europa.eu/chafea/), Grant number 20121205. Duration of the project: 2013-2016. This study was partially supported by Ricerca Corrente funding from Italian Ministry of Health to IRCCS INRCA. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.