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The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads
BACKGROUND: Information and communication technologies (ICT) are key to optimizing the outcomes of the Chronic Care Model (CCM), currently acknowledged as the best synthesis of available evidence for chronic illness prevention and management. At the same time, CCM can offer a needed framework for in...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications Inc.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342659/ https://www.ncbi.nlm.nih.gov/pubmed/25677200 http://dx.doi.org/10.2196/jmir.3547 |
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author | Gammon, Deede Berntsen, Gro Karine Rosvold Koricho, Absera Teshome Sygna, Karin Ruland, Cornelia |
author_facet | Gammon, Deede Berntsen, Gro Karine Rosvold Koricho, Absera Teshome Sygna, Karin Ruland, Cornelia |
author_sort | Gammon, Deede |
collection | PubMed |
description | BACKGROUND: Information and communication technologies (ICT) are key to optimizing the outcomes of the Chronic Care Model (CCM), currently acknowledged as the best synthesis of available evidence for chronic illness prevention and management. At the same time, CCM can offer a needed framework for increasing the relevance and feasibility of ICT innovation and research in health care. Little is known about how and to what extent CCM and ICT research inform each other to leverage mutual strengths. The current study examines: What characterizes work being done at the crossroads of CCM and ICT research and innovation? OBJECTIVE: Our aim is identify the gaps and potential that lie between the research domains CCM and ICT, thus enabling more substantive questions and opportunities for accelerating improvements in ICT-supported chronic care. METHODS: Using a scoping study approach, we developed a search strategy applied to medical and technical databases resulting in 1054 titles and abstracts that address CCM and ICT. After iteratively adapting our inclusion/exclusion criteria to balance between breadth and feasibility, 26 publications from 20 studies were found to fulfill our criteria. Following initial coding of each article according to predefined categories (eg, type of article, CCM component, ICT, health issue), a 1st level analysis was conducted resulting in a broad range of categories. These were gradually reduced by constantly comparing them for underlying commonalities and discrepancies. RESULTS: None of the studies included were from technical databases and interventions relied mostly on “old-fashioned” technologies. Technologies supporting “productive interactions” were often one-way (provider to patient), and it was sometimes difficult to decipher how CCM was guiding intervention design. In particular, the major focus on ICT to support providers did not appear unique to the challenges of chronic care. Challenges in facilitating CCM components through ICT included poorly designed user interfaces, digital divide issues, and lack of integration with existing infrastructure. CONCLUSIONS: The CCM is a highly influential guide for health care development, which recognizes the need for alignment of system tools such as ICT. Yet, there seem to be alarmingly few touch points between the subject fields of “health service development” and “ICT-innovation”. Bridging these gaps needs explicit and urgent attention as the synergies between these domains have enormous potential. Policy makers and funding agencies need to facilitate the joining of forces between high-tech innovative expertise and experts in the chronic care system redesign that is required for tackling the current epidemic of long-term multiple conditions. |
format | Online Article Text |
id | pubmed-4342659 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | JMIR Publications Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-43426592015-03-16 The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads Gammon, Deede Berntsen, Gro Karine Rosvold Koricho, Absera Teshome Sygna, Karin Ruland, Cornelia J Med Internet Res Original Paper BACKGROUND: Information and communication technologies (ICT) are key to optimizing the outcomes of the Chronic Care Model (CCM), currently acknowledged as the best synthesis of available evidence for chronic illness prevention and management. At the same time, CCM can offer a needed framework for increasing the relevance and feasibility of ICT innovation and research in health care. Little is known about how and to what extent CCM and ICT research inform each other to leverage mutual strengths. The current study examines: What characterizes work being done at the crossroads of CCM and ICT research and innovation? OBJECTIVE: Our aim is identify the gaps and potential that lie between the research domains CCM and ICT, thus enabling more substantive questions and opportunities for accelerating improvements in ICT-supported chronic care. METHODS: Using a scoping study approach, we developed a search strategy applied to medical and technical databases resulting in 1054 titles and abstracts that address CCM and ICT. After iteratively adapting our inclusion/exclusion criteria to balance between breadth and feasibility, 26 publications from 20 studies were found to fulfill our criteria. Following initial coding of each article according to predefined categories (eg, type of article, CCM component, ICT, health issue), a 1st level analysis was conducted resulting in a broad range of categories. These were gradually reduced by constantly comparing them for underlying commonalities and discrepancies. RESULTS: None of the studies included were from technical databases and interventions relied mostly on “old-fashioned” technologies. Technologies supporting “productive interactions” were often one-way (provider to patient), and it was sometimes difficult to decipher how CCM was guiding intervention design. In particular, the major focus on ICT to support providers did not appear unique to the challenges of chronic care. Challenges in facilitating CCM components through ICT included poorly designed user interfaces, digital divide issues, and lack of integration with existing infrastructure. CONCLUSIONS: The CCM is a highly influential guide for health care development, which recognizes the need for alignment of system tools such as ICT. Yet, there seem to be alarmingly few touch points between the subject fields of “health service development” and “ICT-innovation”. Bridging these gaps needs explicit and urgent attention as the synergies between these domains have enormous potential. Policy makers and funding agencies need to facilitate the joining of forces between high-tech innovative expertise and experts in the chronic care system redesign that is required for tackling the current epidemic of long-term multiple conditions. JMIR Publications Inc. 2015-02-06 /pmc/articles/PMC4342659/ /pubmed/25677200 http://dx.doi.org/10.2196/jmir.3547 Text en ©Deede Gammon, Gro Karine Rosvold Berntsen, Absera Teshome Koricho, Karin Sygna, Cornelia Ruland. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.02.2015. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Gammon, Deede Berntsen, Gro Karine Rosvold Koricho, Absera Teshome Sygna, Karin Ruland, Cornelia The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads |
title | The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads |
title_full | The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads |
title_fullStr | The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads |
title_full_unstemmed | The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads |
title_short | The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads |
title_sort | chronic care model and technological research and innovation: a scoping review at the crossroads |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342659/ https://www.ncbi.nlm.nih.gov/pubmed/25677200 http://dx.doi.org/10.2196/jmir.3547 |
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